Protein biochip array technology for cytokine profiling predicts etanercept responsiveness in rheumatoid arthritis.
In rheumatoid arthritis (RA) there are currently no useful indicators to predict a clinical response to tumour necrosis factor-alpha (TNF-alpha) blockade. The purpose of this study was to determine the role of peripheral blood cytokine profiling in differentiating between a good versus poor response to etanercept in RA. Peripheral blood samples were collected at baseline and at 3 months from 33 patients with active disease who were treated twice weekly by etanercept therapy. Responders are defined by the presence of three of four American College of Rheumatology criteria: > or =20% decrease in C-reactive protein (CRP), visual analogue score of disease activity, erythrocyte sedimentation rate and improvement of the disease activity score (28; four values) by > or =1.2 obtained at 3 months. Twelve cytokines were measured from serum collected on days 0 and 90 by proteomic array (protein biochip array, Investigator Evidence, Randox France), including interleukin (IL)-6, TNF-alpha, IL-1a, IL-1b, IL-2, IL-8, interferon-gamma, IL-4, IL-10, monocyte chemoattractant protein (MCP)-1, epidermal growth factor (EGF) and vascular endothelium growth factor. Our results showed that high serum levels of MCP-1 and EGF were associated with a response to etanercept. In addition, the increase of two combined parameters CRP and EGF was predictive of a response to etanercept treatment at 3 months (sensitivity: 87.5% and specificity: 75%, accuracy: 84.4%). These findings suggest that cytokine profiling by proteomic analysis before treatment initiation may help to identify a responder patient to TNF-alpha blocking agents in RA.
Fabre
S
S
Department of Immuno-Rheumatology, Lapeyronie University Hospital, Montpellier, France. s-fabre@chu-montpellier.fr
Dupuy
A M
AM
Dossat
N
N
Guisset
C
C
Cohen
J D
JD
Cristol
J P
JP
Daures
J P
JP
Jorgensen
C
C
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000235:genetics*; D004815:Epidermal Growth Factor / Q000097:blood; D000068800:Etanercept; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D040081:Protein Array Analysis; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D015415:Biomarkers; D016207:Cytokines; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D004815:Epidermal Growth Factor; D002097:C-Reactive Protein; D000068800:Etanercept