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Markers of disease activity and progression on Takayasu arteritis: the utility of PET-RM and serum cytokines


The main challenge in the management of Takayasu's arteritis (TA) consists in evaluating if the patient is in disease activity, once new lesions occur in patients without any clinical or laboratory manifestation. Recent studies ascribe the disease's physiopathology to Th1 and Th17 pathways and its related cytokines. The new hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) offers promising prospects for diagnosis and monitoring in TA. Objective: To assess whether asymptomatic patients and those with nonspecific symptoms of disease activity but with 18F-fluorodeoxyglucose (FDG) activity on PET-MRI have a similar profile of inflammatory tests, serum cytokines and pentraxin 3 (PTX3) to those with clinical disease activity and FDG-PET. Methods: A cross-sectional study will be performed to evaluate disease activity, cytokine levels, PTX3 as well as 18F-FDG uptake in PET/MRI. The emergence of new arterial lesions in comparison to previous angiographic evaluation will be verified with the aorta and aortic branches' magnetic resonance angiography. The plasma cytokines TNF±, IL1², IL2, IL4, IL6, IL10, IL13, IL5, IL17A, IL17E, IL17F, IL18, IL21, IL22, IL23 e IFN³ will be dosed by multiplex technique and PTX will be dosed by ELISA technique. NIH criteria and the Indian Takayasu Clinical Activity Score (ITAS2010) will verify the clinical activity. (AU)

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