Öz
Amaç:
Ailevi Akdeniz ateşi (FMF) serosit, ateş ve artrit atakları ile karakterize olan en yaygın monojenik otoenflamatuvar hastalıktır. Enflamatuvar immünoglobulin süper aile üyesinin bir üyesi olan myeloid hücreler-1 (TREM-1) nötrofiller, monosit ve makrofajlar tarafından üretilir ve enflamatuvar kaskadın alevlenmesinde rol oynar. Çalışmada, FMF’li hastalarda serum çözünür TREM-1 (sTREM-1) seviyelerinin değerlendirilmesi ve klinik durum ile karşılaştırılması amaçlanmıştır.
Yöntem:
Eurofever kriterleriyle tanı konulmuş olan toplam 65 FMF hastası ve 21 sağlıklı kontrol çalışmaya dahil edilmiştir. Gazi Üniversitesi Romatoloji Kliniği’ni izlenen hastalar prospektif olarak çalışmaya alınmış ve üç gruba ayrılmıştır; 1. atak dönemi, 2. interatak dönem, 3. amiloidoz pozitif hastalarda interatak dönemidir. STREM-1 seviyeleri çalışma grubu üyelerinden alınan periferik kandan alınan serum örneklerinde değerlendirilmiştir.
Bulgular:
Yaş, cinsiyet, hastalık süresi ve genetik mutasyonlar gruplar arasında benzerdi. Ayrıca sTREM-1 seviyesi ile devam eden enflamasyon arasında önemli bir korelasyon yoktu, ancak vücut kütle indeksi ve yaşla pozitif bir korelasyon mevcuttu. Ayrıca Otoenflamatuvar Hastalık Aktivite indeksi puanıyla negatif bir korelasyon saptandı (p<0,05).
Sonuç:
Serum sTREM-1 seviyelerinin FMF hastalarının klinik aktivitesinde öngörücü bir rolü olabilir.
Anahtar Kelimeler: Ailevi Akdeniz ateşi, sTREM-1, klinik aktivite
Kaynakça
Roman YM, Hernandez AV, White CM. The Role of Suppressing Inflammation in the Treatment of Atherosclerotic Cardiovascular Disease. Ann Pharmacother 2020;54:1021-9.
Tufan A, Lachmann HJ. Familial Mediterranean fever, from pathogenesis to treatment: a contemporary review. Turk J Med Sci 2020;50:1591-610.
Kharouf F, Tsemach-Toren T, Ben-Chetrit E. IL-1 inhibition in familial Mediterranean fever: clinical outcomes and expectations. Clin Exp Rheumatol 2022;40:1567-74.
Piram M, Frenkel J, Gattorno M, et al; EUROFEVER and EUROTRAPS networks. A preliminary score for the assessment of disease activity in hereditary recurrent fevers: results from the AIDAI (Auto-Inflammatory Diseases Activity Index) Consensus Conference. Ann Rheum Dis 2011;70:309-14.
Sanz Codina M, Zeitlinger M. Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review. Clin Pharmacokinet 2022;61:593-617.
Wu Y, Wang F, Fan X, et al. Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis. Crit Care 2012;16:R229.
Gibot S, Kolopp-Sarda MN, Béné MC, et al. Plasma level of a triggering receptor expressed on myeloid cells-1: its diagnostic accuracy in patients with suspected sepsis. Ann Intern Med 2004;141:9-15.
Kuai J, Gregory B, Hill A, et al. TREM-1 expression is increased in the synovium of rheumatoid arthritis patients and induces the expression of pro-inflammatory cytokines. Rheumatology (Oxford) 2009;48:1352-8.
Murakami Y, Akahoshi T, Aoki N, et al. Intervention of an inflammation amplifier, triggering receptor expressed on myeloid cells 1, for treatment of autoimmune arthritis. Arthritis Rheum 2009;60:1615-23.
Bassyouni IH, Fawzi S, Gheita TA, et al. Clinical Association of a Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1) in Patients with Systemic Lupus Erythematosus. Immunol Invest 2017;46:38-47.
Wang Z, Chi H, Sun Y, et al. Serum sTREM-1 in adult-onset Still’s disease: a novel biomarker of disease activity and a potential predictor of the chronic course. Rheumatology (Oxford) 2020;59:3293-302.
Gorlier C, Sellam J, Laurans L, et al. In familial Mediterranean fever, soluble TREM-1 plasma level is higher in case of amyloidosis. Innate Immun 2019;25:487-90.
Ugurlu S, Egeli BH. In Familial Mediterranean Fever, soluble TREM-1 plasma level is higher in case of amyloidosis. Innate Immun 2020;26:231.
Gattorno M, Hofer M, Federici S, et al; Eurofever Registry and the Paediatric Rheumatology International Trials Organisation (PRINTO). Classification criteria for autoinflammatory recurrent fevers. Ann Rheum Dis 2019;78:1025-32.
Özen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach. Rheumatology (Oxford) 2021;60:3799-808.
Ter Haar NM, Annink KV, Al-Mayouf SM, et al. Development of the autoinflammatory disease damage index (ADDI). Ann Rheum Dis 2017;76:821-30.
Cifci A, Durmaz Ceylan S, Oklu K, et al. A new inflammatory marker in overweight patients: triggering receptor expressed on myeloid cells-1. Bratisl Lek Listy 2020;121:259-62.
Sathe NA, Bhatraju PK, Mikacenic C, et al. Relationships Between Age, Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1), and Mortality Among Critically Ill Adults: A Cohort Study. Shock 2022;57:205-11.
Huang JB, Chen NC, Chen CL, et al. Serum Levels of Soluble Triggering Receptor Expressed on Myeloid Cells-1 Associated with the Severity and Outcome of Acute Ischemic Stroke. J Clin Med 2020;10:61.
Kushner I. C-reactive protein elevation can be caused by conditions other than inflammation and may reflect biologic aging. Cleve Clin J Med 2001;68:535-7.
Ershler WB, Keller ET. Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Annu Rev Med 2000;51:245-70.
Bourdel-Marchasson I, Laksir H, Puget E. Interpreting routine biochemistry in those aged over 65 years: a time for change. Maturitas 2010;66:39-45.
Ibrahim JN, Jounblat R, Delwail A, et al. Ex vivo PBMC cytokine profile in familial Mediterranean fever patients: Involvement of IL-1β, IL-1α and Th17-associated cytokines and decrease of Th1 and Th2 cytokines. Cytokine 2014;69:248-54.
Edel Y, Kliminski V, Pokroy-Shapira E, et al. Elevated plasma level of soluble triggering receptor expressed on myeloid cells-1 is associated with inflammation activity and is a potential biomarker of thrombosis in primary antiphospholipid syndrome. Arthritis Res Ther 2019;21:10.
Tomita H, Ogawa F, Hara T, et al. Elevated serum concentrations of triggering receptor expressed on myeloid cells-1 in diffuse cutaneous systemic sclerosis: association with severity of pulmonary fibrosis. J Rheumatol 2010;37:787-91.
Maria AT, Le Quellec A, Jorgensen C, et al. Adult onset Still’s disease (AOSD) in the era of biologic therapies: dichotomous view for cytokine and clinical expressions. Autoimmun Rev 2014;13:1149-59.
Mukhin NA, Kozlovskaya LV, Bogdanova MV, Rameev VV, Moiseev SV, Simonyan AKh. Predictors of AA amyloidosis in familial Mediterranean fever. Rheumatol Int 2015;35:1257-61.
