title: Fewer subsequent relapses and lower levels of IL-17 in Takayasu arteritis developed after the age of 40 years.
abstract: The clinical characteristics of Takayasu arteritis (TAK) developing in individuals older than 40 years (TAK >40) are little-known.
  
  
  
  We retrospectively analyzed 43 patients with TAK treated at three hospitals in Japan from April 2000 to March 2016. From medical records we collected baseline variables at diagnosis including clinical symptoms, laboratory data, and subsequent relapses. We compared these indices in the patients with TAK onset at >40 years of age (TAK >40) to those with TAK onset ≤40 years (TAK ≤40). Multiplex cytokine/chemokine bead assays were performed using preserved serum supernatants from 24 patients with TAK and 40 healthy donors.
  
  
  
  Of the 43 patients, 20 had TAK >40; this group had significantly fewer instances of orthostatic hypotension (2 (10%) vs. 10 (43%), p = 0.019), carotid bruit (7 (35%) vs. 16 (70%), p = 0.034), and chest pain (0 (0%) vs. 6 (26%), p = 0.023) compared to patients with TAK ≤40 (n = 23). The initial prednisolone dose was significantly lower in TAK >40 (median 30 mg vs. 40 mg per day, p = 0.024). Assessed by the log-rank test, the relapse-free survival rate after remission was significantly higher in the patients with TAK >40 (p = 0.029). The interleukin 17 levels were significantly lower in patients with TAK >40 compared to patients with TAK ≤40 and healthy donors.
  
  
  
  Compared to TAK ≤40, TAK >40 could be treated by lower initial doses of prednisolone to achieve remission, and with fewer relapses. These differences might be due to the difference of T helper 17 (Th17) activity suggested by the cytokine profiles.
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Shoichi
authors.identifier: 0000-0001-5487-4692
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. naoki-iwa@nagasaki-u.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwamoto
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Umeda
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishino
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Koga
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.|Unit of Advanced Preventive Medical Sciences, Departments of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Kawashiri
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ichinose
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hirai
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aramaki
authors.affiliation: Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Iwanaga
authors.affiliation: Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan.
authors.forename: Yasumori
authors.initials: Y
authors.lastname: Izumi
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.|Unit of Rehabilitation Sciences, Department of Locomotive Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.affiliation: Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita
authors.affiliation: Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan.
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Ueki
authors.affiliation: Nagasaki University Hospital Clinical Research Center, Nagasaki, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Sato
authors.affiliation: Unit of Advanced Preventive Medical Sciences, Departments of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000328:Adult; D017668:Age of Onset; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000276:immunology*
chemical_list: D020381:Interleukin-17
keywords: Age; Chemokines; Cytokines; IL-17; Relapse; Takayasu arteritis