Article information
Abstract
Introduction
Dermatomyositis (DM) is an autoimmune disease included in the group of idiopathic inflammatory myopathies. Markers of disease activity are needed for clinical control in order to facilitate adjustment of immunomodulatory therapy. We analyzed the relationship between complement activation products (CAP) and the activity of dermatomyositis and its usefulness in the follow-up of the disease and the prediction of recrudescences related to usual biochemical parameters.
Material and methodsWe studied 16 patients with DM that were followed periodically. In each appointment the degree of cutaneous and muscular activity was assessed and such disease activity was correlated with plasma levels of C3a and C5b-9, measured by ELISA.
ResultsThough we obtained certain correlation between disease activity and plasma levels of C3a and C5b-9, the strength of such correlation was not superior to that obtained by usual biochemical markers. C3a was shown to be the most sensitive marker (100%) with a sufficient specificity (83.3%) in the capability to predict recrudescences.
ConclusionsC3a and, to a lesser extent C5b-9, would be useful in the identification of patients with especially active DM as well as in predicting disease recrudescences. Nevertheless they are not superior to the rest of biochemical markers as indicators of current activity.
Key words:
dermatomyositis
activity
recrudescence
complement system
C3a
C5b-9
creatine phosphokinase
Resumen
Introducción
La dermatomiositis (DM) es una enfermedad de origen autoinmune, incluida en el grupo de las miopatías inflamatorias idiopáticas. En el control clínico de este proceso se precisan marcadores que permitan determinar el grado de actividad de la enfermedad, facilitando así el ajuste a la terapia inmunomoduladora. Se analiza la relación entre los productos de activación del complemento (PAC) y la actividad de la DM y su utilidad en el seguimiento de la enfermedad y en la predicción de las reagudizaciones en relación a los parámetros bioquímicos habituales.
Material y métodosSe estudiaron 16 pacientes con DM, que fueron seguidos periódicamente. En cada revisión se estableció el grado de actividad cutánea y muscular del proceso, y se correlacionó dicha actividad con los niveles plasmáticos de C3a y C5b-9, determinados mediante técnica de ELISA.
ResultadosSi bien se obtuvo cierta correlación entre la actividad del proceso y los niveles plasmáticos de C3a y C5b-9, la intensidad de dicha correlación no superó la obtenida por los marcadores bioquímicos tradicionales. En la capacidad de predicción de reagudizaciones, C3a se mostró como el marcador más sensible (100%), con una especificidad suficiente (83,3%).
ConclusionesC3a y en menor medida C5b-9 serían de utilidad en la identificación de pacientes con DM especialmente activas, así como en la predicción de reagudizaciones del proceso. Sin embargo, no tienen una utilidad superior al resto de marcadores bioquímicos como marcadores de actividad actual.
Palabras clave:
dermatomiositis
actividad
reagudización
sistema del complemento
C3a
C5b-9
creatinfosfoquinasa
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