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Circulating cold-inducible RNA-binding protein levels in microscopic polyangiitis and granulomatosis with
Taejun Yoon1, Jang Woo Ha2, Jung Yoon Pyo3
1Department of Medical Science, BK21 Plus Project, Yonsei University, College of Medicine, Seoul, Korea (Republic of).
Objective:
This study investigated whether circulating cold-inducible RNA-binding protein (CIRP) could be a biomarker to reflect the current activity, function, and damage status in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).
Methods:
This study selected 39 MPA and 26 GPA patients. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV)-specific indices include the Birmingham Vasculitis Activity Index (BVAS), five-factor score (FFS), the Korean version of the Short-Form 36-Item Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS), and the vasculitis damage index (VDI). The highest tertile of BVAS was defined as high activity of AAV.
Results:
The median age of the study subjects was 65.0 years and 53.8% were women. The median BVAS, FFS, SF-36 PCS, MCS, and VDI scores were 12.0, 2.0, 47.5, 50.3, and 3.0, respectively. The median circulating CIRP level was 6.4 ng/mL. Among the four AAV-specific indices, circulating CIRP was significantly correlated with BVAS (r = 0.256). Using the receiver operator characteristic curve, the cut-off of circulating CIRP for high activity of AAV was 6.16 ng/mL. High activity of AAV was identified more frequently in patients with circulating CIRP ≥ 6.16 ng/mL than in those with circulating CIRP < 6.16 ng/mL (48.6% vs. 21.4%). In addition, patients with circulating CIRP ≥ 6.16 ng/mL exhibited a significantly higher risk for high activity of AAV than those with circulating CIRP < 6.16 ng/mL (relative risk 3.474).
Conclusion:
This study suggests the clinical potential of circulating CIRP as a biomarker for reflecting the current BVAS and predicting high activity of AAV in patients with MPA and GPA.
Insights
Circulating cold-inducible RNA-binding protein (CIRP) shows potential as a biomarker for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). Elevated CIRP levels correlate with higher disease activity, suggesting its use in monitoring vasculitis activity.
Area of Science:
- Rheumatology
- Immunology
- Biomarker Discovery
Background:
- Microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are severe forms of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
- Accurate assessment of disease activity and damage is crucial for effective patient management in AAV.
Purpose of the Study:
- To investigate the potential of circulating cold-inducible RNA-binding protein (CIRP) as a biomarker.
- To assess CIRP's ability to reflect current disease activity, function, and damage in MPA and GPA patients.
Main Methods:
- A cohort of 39 MPA and 26 GPA patients was studied.
- Disease activity was assessed using the Birmingham Vasculitis Activity Index (BVAS), and damage was evaluated with the Vasculitis Damage Index (VDI).
- Circulating CIRP levels were measured and correlated with established AAV-specific indices.
Main Results:
- Circulating CIRP levels showed a significant correlation with the Birmingham Vasculitis Activity Index (BVAS).
- A cut-off level of 6.16 ng/mL for circulating CIRP was identified to predict high AAV activity.
- Patients with CIRP levels ≥ 6.16 ng/mL had a significantly higher frequency and risk of high AAV activity.
Conclusions:
- Circulating CIRP demonstrates potential as a clinical biomarker for assessing current disease activity (BVAS).
- CIRP may aid in predicting high disease activity in patients diagnosed with MPA and GPA.
- Further research can explore CIRP's role in routine AAV monitoring.
