Objectives To determine the content of TNF in the serum of children with juvenile scleroderma.
Methods Baseline demographics, clinical characteristics and disease activity parameters have been documented. Determination of the concentration of tumor necrosis factor alpha (TNF-α) held in the serum by ELISA using kits from Immunotech (France).
Results We examined 65 children with juvenile scleroderma (JS) (mean age 12.3±3.6 years), among them 24 children with systemic sclerosis (SS) and 41 children with limited scleroderma (LS). According to the results of the study found a significant increase of TNF-α in the serum of children with JS when compared with the control group. Individual values of TNF-α in serum were elevated in 83.3% children with SS and in 65.8% children with LS. Maximum values of this index were observed in children with rapidly progressive course SS (263.98 pg/ml). TNF-α levels did not differ in patients with diffuse and limited forms of systemic sclerosis. Also there was no correlation with clinical parameter of SS, as skin score. The content of TNF-α was not correlated with patient age and disease duration. Correlation analysis revealed the dependence of the level of TNF-α on the degree of disease activity (r=0.73, P<0.001). The positive relationship of TNF-α content with the content of C-reactive protein (r=0.64, P<0.01). The content of TNF-α was significantly higher in patients with rheumatoid factor higher values than children with normal levels of rheumatoid factor (P<0.05).
Conclusions The results suggest that increasing the level of TNF-α at JS reflects inflammatory disease activity and justifies the use of inhibitors of TNF-α for the treatment of scleroderma in childhood.
Acknowledgements This study would not have been possible without the collaboration of numerous Belarusian pediatric rheumatologists, patients and their parents.
Disclosure of Interest None declared
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