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  • Title: Elevated serum levels of interleukin-1 receptor antagonist in polymyositis/dermatomyositis. A biologic marker of disease activity with a possible role in the lack of acute-phase protein response.
    Author: Gabay C, Gay-Croisier F, Roux-Lombard P, Meyer O, Maineti C, Guerne PA, Vischer T, Dayer JM.
    Journal: Arthritis Rheum; 1994 Dec; 37(12):1744-51. PubMed ID: 7986220.
    Abstract:
    OBJECTIVE: To determine whether the lack of acute-phase protein (APP) response in numerous patients with polymyositis/dermatomyositis (PM/DM) is related to an imbalance between cytokines and cytokine inhibitors. METHODS: Levels of C-reactive protein (CRP), interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF alpha), IL-6, IL-1 receptor antagonist (IL-1ra), TNF soluble receptor 55 kd (sTNFR 55 kd), and sTNFR 75 kd were tested in the serum of 15 patients with PM/DM, 14 patients with spondylarthropathies (SPA), and 12 healthy blood donors. Serum IL-1 beta, TNF alpha, IL-6, IL-1ra, sTNFR were measured by specific immunoassays. RESULTS: Serum levels of CRP were lower in PM/DM patients than in SPA patients. Normal or slightly elevated CRP values were found in 10 of the 15 PM/DM patients, 7 of whom had active myositis. Serum IL-6 levels were significantly higher in SPA patients than in PM/DM patients, whereas serum IL-1ra and sTNFR levels were significantly higher in PM/DM than in SPA patients. IL-1ra levels were particularly elevated in patients with active myositis and decreased in response to treatment. CONCLUSION: These differences in cytokine levels, particularly IL-1ra, between PM/DM and SPA patients are indicative of distinct pathogenic mechanisms. High levels of IL-1ra may account for the weak APP response in some PM/DM patients. Our results suggest that measurement of IL-1ra, together with clinical examination, may provide useful information for the followup of PM/DM patients.
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