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High blood levels of chromogranin A in giant cell arteritis identify patients refractory to corticosteroid treatment

2009; BMJ; Volume: 68; Issue: 2 Linguagem: Inglês

10.1136/ard.2007.086587

1468-2060

Gabriele Di Comite, Pietro Previtali, Carlo Maria Rossi, Giacomo Dell’Antonio, Patrizia Rovere‐Querini, Luisa Praderio, Lorenzo Dagna, Angelo Corti, Claudio Doglioni, A Maseri, M.G. Sabbadini, Angelo A. Manfredi,

Peripheral Neuropathies and Disorders

Giant cell arteritis (GCA) rapidly responds to high-dose corticosteroids. However, smouldering arterial inflammation can persist despite the absence of symptoms and altered acute phase reactants. In patients that are refractory, symptoms relapse during steroid tapering and vascular complications may develop. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are not sensitive enough markers to detect refractory disease.1 The neuroendocrine system regulates innate and acquired immune responses, influencing cytokine synthesis and limiting tissue damage via release of neurotransmitters and peptides in peripheral tissues. Chromogranin A in particular is a candidate marker linking neurogenic inflammation and vascular inflammation.2 We investigated by ELISA, as described previously,3 the …