Author/Editor     Kuret, Tadeja; Frank Bertoncelj, Mojca; Lakota, Katja; Žigon, Polona; Thallinger, Gerhard G.; Kopitar, Andreja Nataša; Čučnik, Saša; Tomšič, Matija; Hočevar, Alojzija; Sodin-Šemrl, Snežna
Title     From active to non-active giant cell arteritis
Type     članek
Vol. and No.     , št. Vol. 8
Publication year     2022
Volume     str. 1-13
ISSN     2296-858X - Frontiers in Medicine (Online)
Language     eng
Abstract     (GCA). We collected blood samples at the baseline, and at weeks 1, 4, 12, 24, and 48 of follow-up, and evaluated short- and long-term effects of glucocorticoids (GC) vs. GC and leflunomide. Our aim was to identify candidate biomarkers that could be used to monitor disease activity and predict an increased risk of a relapse. Following high doses of GC, the numbers of CD4+ T-lymphocytes and B-lymphocytes transiently increased and then subsided when GC dose tapering started at week 4. In contrast, the numbers of neutrophils significantly increased during the follow-up time of 12 weeks compared to pre-treatment time. Neutrophil CD62L rapidly diminished after initiation of GC therapy, however its expression remained low at week 48, only in patients under combinatorial therapy with leflunomide. Levels of acute phase reactant SAA and IL-6 decreased significantly after treatment with GC and leflunomide, while levels of IL-8, IL-18, and CHI3L1 did not change significantly during the follow-up period. CHI3L1 was associated with signs of transmural inflammation and vessel occlusion and might therefore serve as a marker of fully developed active GCA, and a promising therapeutic target. Patients with relapses had higher levels of IL-23 at presentation than patients without relapses (p = 0.021). Additionally, the levels of IL-23 were higher at the time of relapse compared to the last follow-up point before relapse. IL-23 might present a promising biomarker of uncontrolled and active disease and could give early indication of upcoming relapses.
Keywords     arteritis velikanskih celic
glukokortikoidi
leflunomid
giant cell arteritis
glucocorticoids
leflunomide