Adipokine gene expression in peripheral blood of adult and juvenile dermatomyositis patients and their relation to clinical parameters and disease activity measures.
OBJECTIVE
Recently adipokines have been implicated in the regulation of immune and inflammatory responses in autoimmune disease. To investigate the role of adipokines in adult and pediatric patients with newly diagnosed dermatomyositis (DM), we analyzed peripheral blood and skeletal muscle gene expression of four adipokines: visfatin, leptin, adiponectin and resistin.


METHODS
Peripheral blood mononuclear cells (PBMCs) were collected for 21 adult DM, 26 juvenile DM, 5 non-disease adult controls, and 6 non-disease pediatric controls at two time points: baseline and 6 months. Muscle biopsies from 5 adult DM patients and 5 non-disease adult controls were collected at baseline. Similarly, muscle biopsies from 7 juvenile DM patients and 5 non-disease pediatric controls were collected at baseline. The gene expression levels of leptin, adiponectin, resistin, visfatin and related inflammatory cytokines, IL-6, TNF- α, and housekeeping genes GAPDH, B2M, and ACTB were generated using a custom RT(2) Profiler PCR Array.


RESULTS
Visfatin gene expression levels in peripheral blood were significantly higher in newly diagnosed adult DM cases compared to non-disease controls (P = 0.004) and these levels correlated with baseline clinical parameters such as age (r = 0.34, P = 0.020), male sex (r = -0.35, P = 0.017), prednisone use (r = -0.42, P = 0.006), and DMARD use (r = 0.35, P = 0.025). No significant association was found between change in visfatin gene expression levels and change in disease activity measures. While visfatin gene expression was significantly up-regulated in muscle tissue of juvenile DM patients (P = 0.028), in adult DM patients only a trend towards significance was observed (P = 0.08). Also, muscle gene expression levels of resistin were significantly elevated in both adult and juvenile DM patients compared respectively to non-disease adult and pediatric controls. Furthermore, an association between peripheral blood resistin gene expression and DM disease activity, including global, muscle, and extra-skeletal disease activity was also observed.


CONCLUSIONS
Peripheral blood visfatin gene expression and muscle resistin gene expression are significantly increased in newly diagnosed adult DM patients. Further longitudinal studies should explore the possibility of using gene expression levels of adipokines such as visfatin and resistin as novel clinical diagnostic biomarkers in DM.
Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN USA.
Jeannette M
JM
Olazagasti
Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN USA.
Molly
M
Hein
Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN USA ; Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA.
Cynthia S
CS
Crowson
Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN USA.
Consuelo Lopez
CL
de Padilla
Department of Medicine, Division of Rheumatic and Autoimmune Diseases, and Center for Immunology, University of Minnesota, Minneapolis, MN USA.
Erik
E
Peterson
Department of Medicine, Division of Rheumatic and Autoimmune Diseases, and Center for Immunology, University of Minnesota, Minneapolis, MN USA.
Emily C
EC
Baechler
Department of Pediatrics, Duke University School of Medicine, 201 Trent Drive, Durham, NC 27710 USA.
Ann M
AM
Reed
Adipokines; Adiponectin; Biomarkers; Dermatomyositis; Leptin; Resistin; Visfatin