الفهرس 
Juvenile Rheumatoid ArthritisOnly 14 pages are availabe for public view
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Abstract
CXCL9 and its receptor, CXCLR3, had been suggested to play a significant role in the pathophysiology of RA.
The aim of this study was to assess whether serum level of CXCL 9 correlate with disease activity in patients with juvenile rheumatoid arthritis (JRA), and to determine whether these effects predict clinical response.
This study was conducted on 40 children who fulfilled the International League of Associations for Rheumatology (ILAR) criteria of juvenile idiopathic arthritis. Seven children had polyarthritis rheumatoid factor (RF) negative; four children had polyarthritis RF positive, six had oligoarthritis, and 23 had systemic arthritis. They were 25 females and 15 males. Their ages ranged from two to fifteen years [mean= 8.1 ± 4 years]. Their duration of illness ranged between 1 and 120 months with a mean disease duration of 48 ± 24.3 months.
A control group comprised 20 healthy age- and sex-matched children with the studied patients for the purpose of comparison of laboratory data.
Laboratory investigations included routine investigations for JRA, and measurement of the serum CXCL9 by ELISA for all studied groups. Follow up of all JRA patients was carried out with close supervision of their compliance to therapy until stabilization of their condition and quiescence of symptoms by treatment (remission or steady state), when a follow up second blood samples were obtained for laboratory re-evaluation.
The present study revealed that the serum CXCL9 had higher level in activity in patients (870+280pg/ml) compared to control group (67.4+39 pg/ml) with highly statistically significant difference (p<0.001).
We also found that the level of serum CXCL9 in patients in activity (870±280pg/ml) was higher than in patients in remission (420±170pg/ml). Serum level of CXCL9 declined after remission with statistically highly significant difference (p<0.001).
We found that comparison between active and remission groups as regards CRP, ESR and number of tender joints showed statistically significant improvement in remission group as compared to active group.
The current study revealed a highly significant positive correlation between active and remission groups versus DAS28 (p<0.001, p<0.001 respectively). Mean±SD of DAS28 in activity was (6.3±1.6) and in remission or steady state was (3.4±0.8).
The present study revealed that serum concentration of CXCL9 at cutoff value 100 pg/ml could differentiate active patients from patients in remission with a sensitivity of 100 %, and specificity 80 %.
We could assume that chemokine CXCL9 may play an important role in the pathogenesis of JRA and that it may be useful as sensitive biological markers for disease activity in patients with JRA.
In addition, the study revealed that there was no statistical significant difference between the groups as regards age, gender, radiological findings, ANA factor and rheumatoid factor.
Finally we could conclude that the serum levels of CXCL9 are increased in active JRA children and CXCL9 can be a new biomarker indicating disease activity in JRA