ANG-2 as Disease Marker in Children With Juvenile Idiopathic Arthritis

x-ray of knees juvenile rheumatoid arthritis
x-ray of knees juvenile rheumatoid arthritis
When combined with ultrasound examination, ANG-2 can help lead to the appropriate therapy for JIA.

Angiopoetin-2 (ANG-2) may be an important marker of juvenile idiopathic arthritis (JIA), according to research presented at the 2017 Annual European Congress of Rheumatology (EULAR), held June 14-17 in Madrid, Spain.

Researchers from the department of pediatric rheumatology at the Medical University of Lodz, in Poland, evaluated ANG-2 scrum and the correlation between synovial fluid levels in patients with JIA and degree of ultrasound-detected synovial angiogenesis to further clarify ANG-2’s value as a disease activity marker.

They measured serum levels in 63 patients between the age of 1.5 and 17 with JIA and 31 age-matched healthy controls. They also collected synovial fluid from 17 patients with JIA, and assessed disease activity with the Juvenile Arthritis Disease Activity Score-27 (JADAS-27). 

They also performed ultrasound examinations of inflamed joints in all patients with JIA, and evaluated synovial angiogenesis by both power Doppler ultrasonography (PDUS) and the fourth grade vascularity scale (0-3).

According to the researchers, ANG-2 serum levels were higher in children with JIA compared with healthy controls (5.5±1.2 ng/ml vs 1.9±1.4 ng/ml). Serum concentration of ANG-2 in children with JIA increased with disease activity (1.4±0.9 ng/ml vs 1.4±1.0 ng/ml vs 1.8±2.2 ng/ml), whereas ANG-2 levels in the synovial fluid were the highest in children with high disease activity (3.4±2.5 ng vs 12.5±9.5 ng/ml vs 26.4±9.0 ng/ml, P <.05).

In addition, ANG-2 concentration in serum correlates with the synovial vascularization obtained by PDUS (0-3; 1.5±0.8 ng/ml vs 1.3±0.9 ng/ml vs 1.5±1.0 ng/ml vs 13.2±8.7 ng/ml, P <.01). The researchers also observed a similar pattern for ANG-2 levels in synovial fluid and PDUS grade (0-3; 3.8±1.0 ng/ml vs 5.1±4.1 ng/ml vs 13.5±2.0 ng/ml, P <.01), leading them to confirm not only ANG-2’s value as a marker for JIA, but also that when combined with ultrasound examination ANG-2 can help lead to appropriate therapy.

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Swidrowska-Jaros J, Smolewska E. Angiopoetin-2 as a new valuable marker of disease activity in children with juvenile idiopathic arthritis. Presented at: 2017 Annual European Congress of Rheumatology (EULAR); June 14-17, 2017; Madrid, Spain. doi:10.1136/annrheumdis-2017-eular.1185