title: Chromogranin-A production and fragmentation in patients with Takayasu arteritis.
abstract: Chromogranin-A (CgA) is a secretory protein processed into peptides that regulate angiogenesis and vascular cells activation, migration and proliferation. These processes may influence arterial inflammation and remodelling in Takayasu arteritis (TA).
  
  
  
  Plasma levels of full-length CgA (CgA439), CgA fragments lacking the C-terminal region (CgA-FRs) and the N-terminal fragment, CgA1-76 (vasostatin-1, VS-1) were analysed in 42 patients with TA and 20 healthy age-matched controls. Vascular remodelling was longitudinally assessed by imaging. CgA peptides were related to markers of systemic and local inflammation, disease activity and vascular remodelling.
  
  
  
  Levels of CgA-FRs and VS-1 were increased in TA. Treatment with proton-pump inhibitors (PPIs) and arterial hypertension partially accounted for CgA levels and high inter-patient variability. CgA439, CgA-FRs and VS-1 levels did not reflect disease activity or extent. Markers of systemic or local inflammation correlated with higher CgA-FRs and VS-1 in normotensive patients and with higher CgA439 in hypertensive patients. Treatment with non-biologic anti-rheumatic agents was associated with increased CgA-FRs and a distinctive regulation of CgA processing. Reduced blood levels of anti-angiogenic CgA peptides were associated with vascular remodelling in the groups of patients on PPIs and with arterial hypertension.
  
  
  
  The plasma levels of CgA fragments are markedly increased in TA as a consequence of disease- and therapy-related variables. Anti-angiogenic forms of CgA may limit vascular remodelling. Given the effect of the various CgA peptides, it is advisable to limit the therapeutic prescriptions that might influence CgA-derived peptide levels to clearly agreed medical indications until further data become available.
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy. tombetti.enrico@hsr.it.|Vita-Salute San Raffaele University, 20132, Milan, Italy. tombetti.enrico@hsr.it.
authors.forename: Enrico
authors.identifier: 0000-0002-7122-9713
authors.initials: E
authors.lastname: Tombetti
authors.affiliation: Division of Oncology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Colombo
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.|Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Di Chio
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.|Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sartorelli
authors.affiliation: Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Papa
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.|Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Annalaura
authors.initials: A
authors.lastname: Salerno
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: Enrica Paola
authors.initials: EP
authors.lastname: Bozzolo
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Tombolini
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.|Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Benedetti
authors.affiliation: Department of Neuroradiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Godi
authors.affiliation: Genomics of Renal Disease and Hypertension Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lanzani
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.|Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rovere-Querini
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.|Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ambrosi
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.|Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Cobelli
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.|Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sabbadini
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Baldissera
authors.affiliation: Vita-Salute San Raffaele University, 20132, Milan, Italy.|Division of Oncology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Corti
authors.affiliation: Department of Medicine and Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.|Vita-Salute San Raffaele University, 20132, Milan, Italy.
authors.forename: Angelo A
authors.initials: AA
authors.lastname: Manfredi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D053379:Chromogranin A / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D013625:Takayasu Arteritis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D066253:Vascular Remodeling; D055815:Young Adult
chemical_list: D015415:Biomarkers; D053379:Chromogranin A; D010446:Peptide Fragments
keywords: Biomarker; Chromogranin A; Proton-pump inhibitors; Takayasu arteritis; Vascular remodelling; Vasculitis