%0 Journal Article
%T Low Serum Levels of Myeloid Progenitor Inhibitory Factor-1 Predict Good Response to Methotrexate in Rheumatoid Arthritis
%A Varun Dhir
%A Amit Sandhu
%A Nidhi Gupta
%A Veena Dhawan
%A Shefali Sharma
%A Aman Sharma
%J ISRN Inflammation
%D 2013
%R 10.1155/2013/460469
%X Background. Although the benchmark in the treatment of rheumatoid arthritis remains methotrexate, only 70% of patients respond. Thus, there is a need for predictive biomarkers. This study planned to evaluate serum levels of myeloid progenitor inhibitory factor-1 (MPIF-1) and monocyte chemoattractant protein 2 (MCP-2)¡ªas biomarkers. Methods. Patients with rheumatoid arthritis (RA) having high disease activity (DAS28-3v£¿¡Ý£¿5.1) were treated with oral methotrexate (MTX) for 12 weeks. Disease activity was measured by DAS28-3v (Modified Disease Activity Score 3 variables). Serum samples were stored at baseline and 12 weeks. Results. This study included 46 patients (F£¿:£¿M = 35£¿:£¿11) having mean (¡ÀSD) age of 42.6 ¡À 11.3£¿yrs, disease duration of 4.7 ¡À 4.5£¿yrs, and DAS28-3v of 6.1 ¡À 0.8. Serum MPIF1 was elevated in patients compared to controls (1636.7 ¡À 1009.7, 441.2 ¡À 173.8£¿pg/mL, ), but there was no difference in MCP2 levels (31.4 ¡À 11.9, 33.8 ¡À 24.0£¿pg/mL). Baseline MPIF-1 level was lower in good responders (¦¤DAS28-3v£¿¡Ý£¿1.2, ) compared to poor responders (¦¤DAS28-3v£¿<£¿0.6, ) (1171.0 ¡À 670.8, 1816.7 ¡À 1154.1£¿pg/mL, ). On ROC analysis, baseline MPIF1 performed reasonably to predict good response; that is, ¦¤DAS28-3v£¿¡Ý£¿1.2 (AUC 0.68, 95% CI 0.50¨C0.87). Conclusions. Lower baseline MPIF1 level predicted a good response to methotrexate at 12 weeks. 1. Introduction Rheumatoid arthritis is an autoimmune chronic inflammatory disease predominantly affecting the joints [1]. There is a recent emphasis on a ¡°treat to target¡± strategy, with regular monitoring of disease activity and quick adjustments of drugs [2]. Although joint assessment remains the gold standard for disease activity, biomarkers may come to play a complementary role [3]. In the treatment of RA, the benchmark drug remains methotrexate. However, it is effective in only 70% of patients, and an excellent response is seen in only 30% of patients. A common therapeutic strategy is to start with methotrexate, and patients who do not respond to methotrexate are subsequently shifted to other drugs or combinations (other DMARDs or biologicals). However, waiting for response to methotrexate may delay institution of other effective therapies in nonresponders and contribute to joint damage. Thus, there is a need to identify nonresponders to methotrexate upfront to institute other therapies [4] hence the need for activity and predictive biomarkers [5]. Chemokines are small proteins involved in chemoattraction of a variety of cells to site of inflammation, being important in the pathogenesis of RA and may serve as
%U http://www.hindawi.com/journals/isrn.inflammation/2013/460469/