Format

Send to

Choose Destination
Rheumatol Int. 2016 Jun;36(6):769-79. doi: 10.1007/s00296-016-3466-7. Epub 2016 Mar 21.

Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis (CRMO).

Author information

1
Pediatric Rheumatology and Immunology, Faculty of Medicine Carl Gustav Carus, University Children's Hospital Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
2
Children's Hospital, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
3
Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany.
4
University Children's Hospital Würzburg, University of Würzburg, Würzburg, Germany.
5
Pediatric Rheumatology and Immunology, Faculty of Medicine Carl Gustav Carus, University Children's Hospital Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. Christian.hedrich@uniklinikum-dresden.de.
6
Children's Hospital, Vivantes Klinikum im Friedrichshain, Berlin, Germany. Christian.hedrich@uniklinikum-dresden.de.

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO), the most severe form of chronic nonbacterial osteomyelitis, is an autoinflammatory bone disorder. A timely diagnosis and treatment initiation is complicated by the absence of widely accepted diagnostic criteria and an incomplete pathophysiological understanding. The aim of this study was to determine biomarkers for the diagnosis and follow-up of CRMO. Serum of 56 CRMO patients was collected at the time of diagnosis. As controls, sera from treatment-naïve age-matched patients with Crohn's disease (N = 62) or JIA (N = 28) as well as healthy individuals (N = 62) were collected. Multiplex analysis of 25 inflammation markers was performed. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests, canonical discriminant analysis, and mixed model variance analysis. Mostly monocyte-derived serum proteins were detectable and differed significantly between groups: IL-1RA, IL-2R, IL-6, IL-12, eotaxin, MCP-1, MIP-1b, RANTES. Multicomponent discriminant analysis allowed for the definition of algorithms differentiating between CRMO, Crohn's disease, and healthy controls. Persistently high levels of MCP-1, IL-12, sIL-2R correlated with incomplete remission in follow-up samples from CRMO patients. Discrimination algorithms allow differentiation between patients with CRMO or Crohn's disease, and healthy individuals. IL-12, MCP-1, and sIL-2R can act as markers for treatment response. Though confirmation of our findings in larger multiethnical cohorts is warranted, they may prove valuable to differentiate between otherwise healthy individuals or Crohn's disease patients with "bone pain" and CRMO patients. The elevation of mainly monocyte-derived pro-inflammatory serum proteins supports the hypothesis of pro-inflammatory monocyte/macrophages driving inflammation in CRMO.

KEYWORDS:

Autoinflammation; Biomarker; Chemokine; Chronic nonbacterial osteomyelitis; Chronic recurrent multifocal osteomyelitis; Cytokine

PMID:
27000045
DOI:
10.1007/s00296-016-3466-7
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center