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Biomarkers of Takayasu arteritis – Circulating cells, metabolomics, composite scores, and markers of vascular damage

Published:November 03, 2022DOI:https://doi.org/10.1016/j.ijcard.2022.11.001
      We read with great interest the article on biomarkers in Takayasu arteritis (TAK) by Wen et al., which mostly reviewed the association of circulating proteins with TAK disease activity [
      • Wen D.
      • Feng L.
      • Du X.
      • Dong J.Z.
      • Ma C.S.
      Biomarkers in Takayasu arteritis.
      ]. Other potential biomarkers of disease activity include cellular and metabolomic biomarkers. Th17 lymphocytes in the peripheral blood are associated with disease activity in TAK. A population of Th17 lymphocytes which also secrete interferon-gamma (the signature cytokine of Th1 lymphocytes), called Th17.1 lymphocytes, were also recently reported to be elevated in active TAK [
      • Singh K.
      • Rathore U.
      • Rai M.K.
      • Behera M.R.
      • Jain N.
      • Ora M.
      • et al.
      Novel Th17 lymphocyte populations, Th17.1 and PD1+Th17, are increased in Takayasu arteritis, and both Th17 and Th17.1 sub-populations associate with active disease.
      ]. Glutamine-to-glucose ratio derived from metabolomics of serum could distinguish active from inactive TAK with an area under the receiver operating characteristics curve of 0.76 [
      • Kumar U.
      • Jain A.
      • Guleria A.
      • R V.K.
      • Misra D.P.
      • Goel R.
      • et al.
      Circulatory glutamine/glucose ratio for evaluating disease activity in Takayasu arteritis: a NMR based serum metabolomics study.
      ]. Another recent paper reported that a combination of information derived from mean standardized uptake value from positron emission tomography, serum interleukin-2 receptor, and erythrocyte sedimentation rate (ESR) distinguished active TAK better than ESR or National Institutes of Health disease activity criteria [
      • Ma L.Y.
      • Wu B.
      • Jin X.J.
      • Sun Y.
      • Kong X.F.
      • Ji Z.F.
      • et al.
      A novel model to assess disease activity in Takayasu arteritis based on 18F-FDG-PET/CT: a Chinese cohort study.
      ]. Recent studies have also identified circulating biomarkers of vascular damage. The enhanced liver fibrosis score (a composite of the circulating levels of tissue inhibitor of metalloproteinase I, hyaluronic acid, and the amino-terminal peptide of procollagen type III) correlated moderately with vascular damage denoted by the angiographic Combined Arteritis Damage Score and the clinical Takayasu Arteritis Damage Score [
      • Stojanovic M.
      • Raskovic S.
      • Milivojevic V.
      • Miskovic R.
      • Soldatovic I.
      • Stankovic S.
      • et al.
      Enhanced liver fibrosis score as a biomarker for vascular damage assessment in patients with Takayasu arteritis-a pilot study.
      ]. Discussion of biomarkers of active TAK related to circulating cells, metabolomics, assessing biomarkers of vascular damage in TAK, and reporting composite outcome measures including imaging and circulating biomarkers in this review would have provided a more complete picture.
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      References

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        • Feng L.
        • Du X.
        • Dong J.Z.
        • Ma C.S.
        Biomarkers in Takayasu arteritis.
        Int. J. Cardiol. 2022; (online ahead of print)
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        • Rathore U.
        • Rai M.K.
        • Behera M.R.
        • Jain N.
        • Ora M.
        • et al.
        Novel Th17 lymphocyte populations, Th17.1 and PD1+Th17, are increased in Takayasu arteritis, and both Th17 and Th17.1 sub-populations associate with active disease.
        J. Inflamm. Res. 2022; 15: 1521-1541
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        • Guleria A.
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        Circulatory glutamine/glucose ratio for evaluating disease activity in Takayasu arteritis: a NMR based serum metabolomics study.
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        • Ma L.Y.
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        A novel model to assess disease activity in Takayasu arteritis based on 18F-FDG-PET/CT: a Chinese cohort study.
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        Enhanced liver fibrosis score as a biomarker for vascular damage assessment in patients with Takayasu arteritis-a pilot study.
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