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Updated: May 8, 2026

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Soluble Co-Inhibitory Immune Checkpoint Molecules Are Increased in Patients With Polymyalgia Rheumatica Without

Elvis Hysa1, Dario Camellino2, Christian Dejaco3

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Summary
This summary is machine-generated.

Soluble immune checkpoint molecules (sICMs) are significantly elevated in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), differentiating patients from healthy individuals. These sICMs show no correlation with clinical features but may indicate complex immune interplay in active disease.

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Area of Science:

  • Immunology
  • Rheumatology
  • Oncology (related to immune checkpoint inhibitors)

Background:

  • Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) pathogenesis involves immune dysregulation.
  • Immune checkpoint inhibitors in cancer therapy can trigger PMR and GCA as immune-related adverse events.

Purpose of the Study:

  • To investigate the relationship between soluble immune checkpoint molecules (sICMs) and the clinical/imaging features of PMR and GCA.
  • To assess the diagnostic potential of sICMs in differentiating PMR and GCA patients from healthy controls.

Main Methods:

  • A cross-sectional study comparing PMR patients (with and without GCA) to age- and sex-matched healthy controls.
  • Measurement of soluble immune checkpoint molecules: anticytotoxic T-lymphocyte-associated antigen 4 (sCTLA-4), programmed cell death protein 1 (PD-1), and PD-1 ligands (PD-L1, PD-L2) using ELISA.
  • Clinical, laboratory, and 18F-FDG PET/CT imaging assessments were performed.

Main Results:

  • Patients with PMR and GCA exhibited significantly higher concentrations of all measured sICMs compared to controls (P < 0.001).
  • Soluble immune checkpoint molecules, particularly PD-L1 and PD-L2, demonstrated strong discriminative capacity between patients and controls.
  • Correlations between sICM levels and clinical or imaging features were generally weak or absent, irrespective of disease phenotype or glucocorticoid treatment.

Conclusions:

  • Soluble immune checkpoint molecules are significantly elevated in active PMR and GCA, serving as robust biomarkers for disease differentiation.
  • While not correlating with clinical manifestations, elevated sICMs suggest a potential role in the complex immune response underlying these conditions.