PLoS ONE (Jan 2015)

Serum biomarkers in patients with relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss).

  • Christian Dejaco,
  • Bastian Oppl,
  • Paul Monach,
  • David Cuthbertson,
  • Simon Carette,
  • Gary Hoffman,
  • Nader Khalidi,
  • Curry Koening,
  • Carol Langford,
  • Kathleen McKinnon-Maksimowicz,
  • Philip Seo,
  • Ulrich Specks,
  • Steven Ytterberg,
  • Peter A Merkel,
  • Jochen Zwerina

DOI
https://doi.org/10.1371/journal.pone.0121737
Journal volume & issue
Vol. 10, no. 3
p. e0121737

Abstract

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Previous studies suggest a role for eotaxin-3, TARC/CCL17 and IgG4 in newly-diagnosed patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss) with highly active disease. The role of these biomarkers in relapsing disease is unclear.Serum levels of TARC/CCL17, eotaxin-3, IgG4, and IgG4/IgG ratio were determined in serum samples from a longitudinal cohort of patients with EGPA (105 visits of 25 patients). Epidemiological, clinical and laboratory data were available for all visits.At the first visit, 80% of patients were using glucocorticoids and 68% additional immunosuppressive drugs. Disease flares were seen at 18 visits. The median BVAS and BVAS/WG scores at time of relapse were 4 and 2, respectively. None of the biomarkers tested were useful to discriminate between active disease and remission. Patients treated with prednisone had lower eotaxin-3 and eosinophil levels compared to patients not taking glucocorticoids irrespective of disease activity. Use of immunosuppressive agents was not associated with biomarker levels.Serum levels of TARC/CCL17, eotaxin-3, IgG4, and IgG4/IgG ratio do not clearly differentiate active and inactive disease in established EGPA. Defining biomarkers in EGPA remains a challenge especially during times of glucocorticoid use.