High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis
IntroductionGlucocorticoids (GCs) are widely used as a treatment for rheumatoid arthritis (RA), leading to high cumulative doses in long-term treated patients. The impact of a high cumulative GC dose on the systemic inflammatory response in RA remains poorly understood.MethodsWe investigated long-tr...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1505615/full |
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| author | Anna Petrackova Pavel Horak Jakub Savara Jakub Savara Martina Skacelova Eva Kriegova |
| author_facet | Anna Petrackova Pavel Horak Jakub Savara Jakub Savara Martina Skacelova Eva Kriegova |
| author_sort | Anna Petrackova |
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| description | IntroductionGlucocorticoids (GCs) are widely used as a treatment for rheumatoid arthritis (RA), leading to high cumulative doses in long-term treated patients. The impact of a high cumulative GC dose on the systemic inflammatory response in RA remains poorly understood.MethodsWe investigated long-treated patients with RA (n = 72, median disease duration 14 years) through blood counts and the serum levels of 92 inflammation-related proteins, and disease activity was assessed using the Simple Disease Activity Index (SDAI). Patients were grouped based on the cumulative GC dose, with a cut-off value of 20 g (low/high, n = 49/23).Results and discussionPatients with a high cumulative GC dose within the active RA group had elevated serum levels in 23 inflammation-related proteins compared with patients with a low dose (cytokines/soluble receptors: CCL3, CCL20, CCL25, IL-8, CXCL9, IL-17A, IL-17C, IL-18, sIL-18R1, IL-10, sIL-10RB, OSM and sOPG; growth factors: sTGFα and sHGF; other inflammatory mediators: caspase 8, STAMBP, sCDCP1, sirtuin 2, 4E-BP1, sCD40, uPA and axin-1; pcorr < 0.05). In non-active RA, the high and low GC groups did not differ in analysed serum protein levels. Moreover, patients with active RA with a high GC dose had an increased white blood cell count, increased neutrophil–lymphocyte and platelet–lymphocyte ratios and a decreased lymphocyte–monocyte ratio compared with the low dose group (p < 0.05). This is the first study to report elevated serum levels in inflammation-related proteins and deregulated blood counts in patients with active RA with a high cumulative GC dose. The elevated systemic inflammation highlights the importance of improving care for patients receiving high cumulative GC doses. |
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| issn | 1664-3224 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-63b3553cd43e486aa8063ad3129e849b2025-08-20T01:57:59ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.15056151505615High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritisAnna Petrackova0Pavel Horak1Jakub Savara2Jakub Savara3Martina Skacelova4Eva Kriegova5Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital, Olomouc, CzechiaDepartment of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital, Olomouc, CzechiaDepartment of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital, Olomouc, CzechiaDepartment of Computer Science, Faculty of Electrical Engineering and Computer Science, Technical University of Ostrava, Ostrava, CzechiaDepartment of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital, Olomouc, CzechiaDepartment of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital, Olomouc, CzechiaIntroductionGlucocorticoids (GCs) are widely used as a treatment for rheumatoid arthritis (RA), leading to high cumulative doses in long-term treated patients. The impact of a high cumulative GC dose on the systemic inflammatory response in RA remains poorly understood.MethodsWe investigated long-treated patients with RA (n = 72, median disease duration 14 years) through blood counts and the serum levels of 92 inflammation-related proteins, and disease activity was assessed using the Simple Disease Activity Index (SDAI). Patients were grouped based on the cumulative GC dose, with a cut-off value of 20 g (low/high, n = 49/23).Results and discussionPatients with a high cumulative GC dose within the active RA group had elevated serum levels in 23 inflammation-related proteins compared with patients with a low dose (cytokines/soluble receptors: CCL3, CCL20, CCL25, IL-8, CXCL9, IL-17A, IL-17C, IL-18, sIL-18R1, IL-10, sIL-10RB, OSM and sOPG; growth factors: sTGFα and sHGF; other inflammatory mediators: caspase 8, STAMBP, sCDCP1, sirtuin 2, 4E-BP1, sCD40, uPA and axin-1; pcorr < 0.05). In non-active RA, the high and low GC groups did not differ in analysed serum protein levels. Moreover, patients with active RA with a high GC dose had an increased white blood cell count, increased neutrophil–lymphocyte and platelet–lymphocyte ratios and a decreased lymphocyte–monocyte ratio compared with the low dose group (p < 0.05). This is the first study to report elevated serum levels in inflammation-related proteins and deregulated blood counts in patients with active RA with a high cumulative GC dose. The elevated systemic inflammation highlights the importance of improving care for patients receiving high cumulative GC doses.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1505615/fullautoimmune diseasesadverse effects of glucocorticoidssystemic inflammationcytokine profilelong-treated patientsdisease activity |
| spellingShingle | Anna Petrackova Pavel Horak Jakub Savara Jakub Savara Martina Skacelova Eva Kriegova High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis Frontiers in Immunology autoimmune diseases adverse effects of glucocorticoids systemic inflammation cytokine profile long-treated patients disease activity |
| title | High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis |
| title_full | High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis |
| title_fullStr | High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis |
| title_full_unstemmed | High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis |
| title_short | High cumulative glucocorticoid dose is associated with increased levels of inflammation-related mediators in active rheumatoid arthritis |
| title_sort | high cumulative glucocorticoid dose is associated with increased levels of inflammation related mediators in active rheumatoid arthritis |
| topic | autoimmune diseases adverse effects of glucocorticoids systemic inflammation cytokine profile long-treated patients disease activity |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1505615/full |
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