Selective upregulation of the soluble pattern recognition receptor PTX3 and of VEGF in giant cell arteritis : Relevance for recent optic nerve ischemia

OBJECTIVE: To assess local expression and plasma levels of pentraxin-3 (PTX3) in Giant Cell Arteritis (GCA) patients. METHODS: Plasma and serum samples were obtained from 75 GCA patients (among which 20 experienced optic nerve ischemia in the previous three weeks and 24 had symptoms onset in the previous six months and no optic nerve ischemia history) and 63 controls (35 age-matched healthy subjects, 15 patients with rheumatoid arthritis and 13 with chronic stable angina). In nine recently diagnosed GCA patients, circulating levels of IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12 p70, CCL2/MCP-1, CCL3/MIP-1α, CCL4/MIP-1β, CCL11/eotaxin, CXCL9/MIG, CXCL10/IP10, TNF-α, IFN-γ, VEGF, GM-CSF and FasL were measured via a multiplexed cytometric assay. PTX3 and VEGF concentrations were assessed by ELISA. PTX3 and CD68 expression were determined by immunohistochemistry and immunofluorescence on temporal artery samples. RESULTS: GCA patients with very recent optic nerve ischemia had significantly higher PTX3 and VEGF levels compared to other GCA patients and controls. GCA patients with a disease history of less than six months had significantly higher PTX3 levels compared to other GCA patients and controls. Immunohistochemistry revealed selective PTX3 expression in the wall of inflamed arteries. CONCLUSION: Local expression of PTX3 is a feature of vascular inflammation in GCA; elevated circulating levels of PTX3 identify patients with very recent optic nerve ischemia or a recent diagnosis. Optic nerve ischemia is also associated to increased VEGF circulating levels. © 2011 American College of Rheumatology.