Abstract

Objective

This study aimed to evaluate subclinical atherosclerosis in patients with polymyalgia rheumatica (PMR) using carotid intima-media thickness (CIMT) and plaque assessment, and to investigate the potential association between PMR and inflammatory [interleukin (IL)-6, IL-8, IL-32, interferon (IFN)-γ, pentraxin-3 (PTX-3)] and anti-inflammatory (IL-5, IL-33, adiponectin) levels.

Methods

Between April 2011 and June 2012, thirty-three patients with PMR and twenty-eight healthy controls were enrolled. Clinical data, atherosclerotic risk factors, and biochemical parameters were recorded. Serum levels of IL-5, IL-6, IL-8, IL-32, IL-33, IFN-γ, adiponectin, and PTX-3 were measured using enzyme-linked immunosorbent assay. CIMT and plaque presence were evaluated by high-resolution ultrasonography.

Results

The mean age of the PMR group was 66.3±9.6 years and of the controls 62.5±5.1 years (p=0.103). No significant differences were observed regarding atherosclerotic risk factors. IL-5 levels were significantly higher in PMR patients compared to controls (167.7±16.6 vs. 155±18.3 pg/mL; p=0.009). PTX-3 levels were also significantly higher in the PMR group [433 (227.5-1059.5) vs. 347.3 (251-697.5) pg/mL; p=0.008]. No significant differences were detected for IL-6, IL-8, IL-32, IL-33, IFN-γ, or adiponectin levels between PMR and control groups. Mean CIMT (0.749±0.101 vs. 0.715±0.055 mm; p=0.270) and carotid plaque presence (20.7% vs. 4.2%; p=0.108) were not significantly different between groups.

Conclusion

This is the first study which has been demonstrated significantly elevated IL-5 levels in patients with PMR. Increased PTX-3 levels may indicate the presence of subclinical vascular inflammation. However, the absence of significant differences in CIMT and plaque presence suggests a possible influence of corticosteroid therapy on vascular parameters. These findings highlight a potential role of IL-5 in PMR pathogenesis, warranting further large-scale investigations.