1M Hafez, 2S Hawas, MF EL-Batouty, 1Z
EL-Morsy, 1A Mansour, 1H AL-Marsafawy, and 4B
EL-Deek.
Departments
of 1Pediatrics, 2Microbiology and Medical Immunology, 3Rheumatology
and Rehabilitation & 4Biostatistics and Community Medicine,
Mansoura University.
This work
investigates circulating tumour necrosis factor receptors (sTNFR) (P55 and P75)
and Interleukin-2 receptors (IL-2R) in patients with active Juvenile rheumatoid
arthritis (JRA), in a trial to evaluate their value in clinical assessment and
response to treatment. The study included 44 children with JRA and 20 healthy
controls. All patients had active disease defined by the presence of arthritis,
and elevated C-reactive protein (CRP) and erythrocytic sedimentation rate (ESR)
levels. Patients were enrolled according to their clinical diagnosis into three
groups: G1, included 18 patients with polyarticular onset, G2; 18 with
pauciarticular onset; and G3 with systemic onset. They entered a prospective
and randomized double blind trial for therapy with either prednisone or non
steroidal anti-inflammatory drugs (NSAIDS). sTNFR and sIL-2R were measured
before and 48 weeks after heatment. The three receptors were significantly
higher in active JRA as compared to healthy controls, regardless of the
clinical types of JRA. However, significant reduction was demonstrated after
treatment. On the other hand, no significant difference in the percentages of
reductions was detected in patients treated by prednisone as compared to those
treated with NSAIDs. Patients with marked improvement after treatment showed
significant reduction (P < 0.001) in TNFR P55. In conclusion, TNFR, P55 may
be a useful marker in the evaluation of clinical status and therapeutic
response in patients with JRA.