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Increased expression of proto-oncogene survivin predicts Joint destruction and persistent disease activity in early rheumatoid arthritis

Svensson, Björn; Hafström, Ingiäld; Forslind, Kristina LU ; Albertsson, Kristina; Tarkowski, Andrej and Bokarewa, Maria (2010) In Annals of Medicine 42(1). p.45-54
Abstract

Background. Rheumatoid arthritis (RA) is characterized by an uncontrolled spread of destructive joint inflammation resembling malignancy. Epidemiological studies have established strong correlation between inflammation and predisposition for cancer. Here we assess the predictive role of the circulating proto-oncogene survivin for clinical and radiological outcome of early RA. Patients and methods. Serum survivin was measured by sandwich ELISA in 651 patients with early RA (mean duration 6 months). X-rays of hands and feet were prospectively obtained at base-line and after 1, 2, and 5 years and evaluated for the presence of bone destruction by a modified Sharp method. The predictive value of survivin for radiological destruction was... (More)

Background. Rheumatoid arthritis (RA) is characterized by an uncontrolled spread of destructive joint inflammation resembling malignancy. Epidemiological studies have established strong correlation between inflammation and predisposition for cancer. Here we assess the predictive role of the circulating proto-oncogene survivin for clinical and radiological outcome of early RA. Patients and methods. Serum survivin was measured by sandwich ELISA in 651 patients with early RA (mean duration 6 months). X-rays of hands and feet were prospectively obtained at base-line and after 1, 2, and 5 years and evaluated for the presence of bone destruction by a modified Sharp method. The predictive value of survivin for radiological destruction was calculated using multivariate regression models including antibodies against cyclic citrullinated peptides (aCCP) and rheumatoid factor (RF). Remission was assessed by the EULAR (European League Against Rheumatism) criteria and by criteria proposed by Mkinen. Results. At base-line, 391 patients (60%) had high levels of survivin. Radiological progression at 5 years was significantly more frequent (P 0.001) among survivin-positive patients than among survivin-negative. Survivin positivity predicted radiological progression independently of aCCP and RF. The positive predictive value of survivin was proved both in the group of patients with and in the group without erosions at base-line. The combination of positive tests for both survivin and aCCP had the highest prediction for radiological progression (positive predictive value 0.75). Additionally, a positive test for survivin was an independent predictor of not being in remission. Conclusion. Detection of survivin in early RA predicted joint destruction and failure of achieving remission after 5 years in patients with early RA.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Oncogenes, Prognosis, Remission, Rheumatoid arthritis, Survivin
in
Annals of Medicine
volume
42
issue
1
pages
10 pages
publisher
Informa Healthcare
external identifiers
  • scopus:75149157986
ISSN
0785-3890
DOI
10.3109/07853890903376280
language
English
LU publication?
yes
id
8a51692c-eab4-4d0a-b76b-b26826639a0d
date added to LUP
2019-08-13 17:42:05
date last changed
2019-08-14 04:44:10
@article{8a51692c-eab4-4d0a-b76b-b26826639a0d,
  abstract     = {<p>Background. Rheumatoid arthritis (RA) is characterized by an uncontrolled spread of destructive joint inflammation resembling malignancy. Epidemiological studies have established strong correlation between inflammation and predisposition for cancer. Here we assess the predictive role of the circulating proto-oncogene survivin for clinical and radiological outcome of early RA. Patients and methods. Serum survivin was measured by sandwich ELISA in 651 patients with early RA (mean duration 6 months). X-rays of hands and feet were prospectively obtained at base-line and after 1, 2, and 5 years and evaluated for the presence of bone destruction by a modified Sharp method. The predictive value of survivin for radiological destruction was calculated using multivariate regression models including antibodies against cyclic citrullinated peptides (aCCP) and rheumatoid factor (RF). Remission was assessed by the EULAR (European League Against Rheumatism) criteria and by criteria proposed by Mkinen. Results. At base-line, 391 patients (60%) had high levels of survivin. Radiological progression at 5 years was significantly more frequent (P 0.001) among survivin-positive patients than among survivin-negative. Survivin positivity predicted radiological progression independently of aCCP and RF. The positive predictive value of survivin was proved both in the group of patients with and in the group without erosions at base-line. The combination of positive tests for both survivin and aCCP had the highest prediction for radiological progression (positive predictive value 0.75). Additionally, a positive test for survivin was an independent predictor of not being in remission. Conclusion. Detection of survivin in early RA predicted joint destruction and failure of achieving remission after 5 years in patients with early RA.</p>},
  author       = {Svensson, Björn and Hafström, Ingiäld and Forslind, Kristina and Albertsson, Kristina and Tarkowski, Andrej and Bokarewa, Maria},
  issn         = {0785-3890},
  keyword      = {Oncogenes,Prognosis,Remission,Rheumatoid arthritis,Survivin},
  language     = {eng},
  month        = {02},
  number       = {1},
  pages        = {45--54},
  publisher    = {Informa Healthcare},
  series       = {Annals of Medicine},
  title        = {Increased expression of proto-oncogene survivin predicts Joint destruction and persistent disease activity in early rheumatoid arthritis},
  url          = {http://dx.doi.org/10.3109/07853890903376280},
  volume       = {42},
  year         = {2010},
}