In active juvenile dermatomyositis, elevated eotaxin and MCP-1 and cholesterol levels in the upper normal range are associated with cardiac dysfunction

Rheumatology (Oxford). 2014 Dec;53(12):2214-22. doi: 10.1093/rheumatology/keu256. Epub 2014 Jul 4.

Abstract

Objective: The aim of this study was to examine the influence of chemokines and lipids on cardiac function in patients with active and inactive JDM and matched controls.

Methods: Fifty-four JDM patients were clinically examined a median 16.8 years (range 2-38) after disease onset and compared with 54 sex- and age-matched controls. Inactive disease was defined by the PRINTO criteria. Serum levels of chemokines were analysed by Luminex technology. Echocardiography was performed and analysed blinded to patient information. Long-axis strain and e' were used as parameters of systolic and diastolic function, respectively.

Results: In patients, but not in controls, eotaxin and monocyte chemoattractant protein 1 (MCP-1) correlated with systolic (r = -0.65 and r = -0.45) and diastolic (r = -0.59 and r = -0.65) function, particularly in those with active disease (systolic function, r = -0.74 and r = -0.60; diastolic function, r = -0.69 and r = -0.80). Total cholesterol level was lower in patients than controls [mean 4.19 mmol/l (s.d. 0.82) vs 4.60 (0.87), P ≤ 0.01]. However, total cholesterol levels in the upper normal range were associated with systolic (r = -0.56, P < 0.01) and diastolic (r = -0.64, P < 0.001) dysfunction and with high eotaxin and MCP-1 (r = 0.56 and r = 0.50, P < 0.01) in patients with active disease, but not in those with inactive disease or in controls (all r < ±0.2).

Conclusion: In the active disease state of JDM, eotaxin and MCP-1 were associated with cardiac dysfunction, possibly through sustained inflammation. In those with active disease and cholesterol levels in the upper normal range, eotaxin and MCP-1 might enhance susceptibility to cardiac dysfunction.

Keywords: cardiovascular; cytokines and inflammatory mediators; myositis and muscle disease; paediatric/juvenile rheumatology; vasculitis.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / etiology
  • Case-Control Studies
  • Chemokine CCL11 / blood
  • Chemokine CCL2 / blood
  • Chemokines / blood*
  • Child
  • Child, Preschool
  • Cholesterol / blood*
  • Dermatomyositis / blood*
  • Dermatomyositis / complications
  • Echocardiography, Doppler / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Reference Values
  • Young Adult

Substances

  • Biomarkers
  • CCL11 protein, human
  • CCL2 protein, human
  • Chemokine CCL11
  • Chemokine CCL2
  • Chemokines
  • Cholesterol