title: IL-33 and soluble ST2 levels as novel predictors for remission and progression of carotid plaque in early rheumatoid arthritis: A prospective study.
abstract: OBJECTIVE
  To study the association between the baseline IL-33 and soluble ST2 (sST2) levels with disease remission and progression of carotid atherosclerosis in early rheumatoid arthritis (ERA) patients.
  
  
  METHODS
  A total of 98 ERA patients were enrolled. Disease activity and the presence of carotid plaque were evaluated at baseline and 12 months later. Plasma IL-33 and sST2 levels were determined using enzyme-linked immunosorbent assay kits.
  
  
  RESULTS
  Baseline IL-33 and sST2 levels were associated with inflammatory markers and cardiovascular (CV) risk factors. Overall, 44(45%), 18(18%), and 21(21%) patients achieved remission based on 28-joint disease activity score (DAS28), Boolean, and simplified disease activity score (SDAI) criteria at 12 months, respectively. Patients with detectable IL-33 at baseline were less likely to achieve DAS28 (P = 0.010) and SDAI remission (P = 0.021), while a lower baseline sST2 level was able to predict DAS28, Boolean, and SDAI remission (P = 0.005, 0.001, and <0.001, respectively). Using multivariate analysis, a lower baseline sST2 level independently predict Boolean (OR = 0.789; P = 0.005) and SDAI remission (0.812; P = 0.008). Regarding carotid atherosclerosis, 9/98(9.2%) patients had plaque progression at 12 months. Baseline IL-33 was detectable in 8/9(89%) and 42/83(51%) of patients with and without plaque progression respectively (P = 0.029). Baseline detectable IL-33 was an independent predictor for plaque progression after adjusting for traditional CV risk factors (P = 0.017).
  
  
  CONCLUSIONS
  Lower baseline sST2 levels independently predict disease remission and baseline detectable IL-33 independently predicts carotid plaque progression in ERA patients. This study suggests that inflammation induced by the IL-33/ST2 axis may play a significant role in the development of cardiovascular disease in RA.
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Jiayun
authors: J
authors: Shen
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Qing
authors: Q
authors: Shang
authors: Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Chun-Kwok
authors: CK
authors: Wong
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Edmund K
authors: EK
authors: Li
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Shang
authors: S
authors: Wang
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Rui-Jie
authors: RJ
authors: Li
authors: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
authors: Ka-Lai
authors: KL
authors: Lee
authors: Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Republic of Singapore.
authors: Ying-Ying
authors: YY
authors: Leung
authors: Department of Medicine, Princess Margaret Hospital, Hong Kong, China.
authors: King-Yee
authors: KY
authors: Ying
authors: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China.
authors: Cheuk-Wan
authors: CW
authors: Yim
authors: Department of Medicine and Geriatrics, Taipo Hospital, Hong Kong, China.
authors: Emily W
authors: EW
authors: Kun
authors: Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China.
authors: Moon-Ho
authors: MH
authors: Leung
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Martin
authors: M
authors: Li
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Tena K
authors: TK
authors: Li
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Tracy Y
authors: TY
authors: Zhu
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Shui-Lian
authors: SL
authors: Yu
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Woon-Pang
authors: WP
authors: Kuan
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors: Cheuk-Man
authors: CM
authors: Yu
authors: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: lstam@cuhk.edu.hk.
authors: Lai-Shan
authors: LS
authors: Tam
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D011956:Receptors, Cell Surface / Q000097:blood*; D012074:Remission Induction; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D011956:Receptors, Cell Surface
keywords: Atherosclerosis; Carotid plaque; Disease remission; Early rheumatoid arthritis; IL-33; Soluble ST2