Serum interleukin-6 and CCL11/eotaxin may be suitable biomarkers for the diagnosis of chronic nonbacterial osteomyelitis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Sigrun Ruth Hofmann - , Department of Paediatrics (Author)
  • Fanny Böttger - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Ursula Range - , Institute for Medical Informatics and Biometry (Author)
  • Christian Lück - , Institute of Medical Microbiology and Virology (Author)
  • Henner Morbach - , University of Würzburg (Author)
  • Hermann Joseph Girschick - , Vivantes Hospitals Berlin (Author)
  • Meinolf Suttorp - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Christian Michael Hedrich - , Department of Child and Adolescent Psychiatry and Psychotherapy , University of Liverpool (UOL), Alder Hey Children's NHS Foundation Trust (Author)

Abstract

Objectives: Chronic recurrent multifocal osteomyelitis (CRMO), the most severe form of chronic nonbacterial osteomyelitis (CNO), is an autoinflammatory bone disorder. In the absence of diagnostic criteria or biomarkers, CNO/CRMO remains a diagnosis of exclusion. The aim of this study was to identify biomarkers for diagnosing multifocal disease (CRMO). Study design: Sera from 71 pediatric CRMO patients, 11 patients with osteoarticular infections, 62 patients with juvenile idiopathic arthritis (JIA), 7 patients with para-infectious or reactive arthritis, and 43 patients with acute leukemia or lymphoma, as well as 59 healthy individuals were collected. Multiplex analysis of 18 inflammation- and/or bone remodeling-associated serum proteins was performed. Statistical analysis included univariate ANOVA, discriminant analysis, univariate receiver operating characteristic (ROC) analysis, and logistic regression analyses. Results: For 14 of 18 blood serum proteins, significant differences were determined between CRMO patients, at least one alternative diagnosis, or healthy controls. Multi-component discriminant analysis delivered five biomarkers (IL-6, CCL11/eotaxin, CCL5/RANTES, collagen Ia, sIL-2R) for the diagnosis of CRMO. ROC analysis allowed further reduction to a core set of 2 biomarkers (CCL11/eotaxin, IL-6) that are sufficient to discern between CRMO, healthy controls, and alternative diagnoses. Conclusion: Serum biomarkers CCL11/eotaxin and IL-6 differentiate between patients with CRMO, healthy controls, and alternative diagnoses (leukemia and lymphoma, osteoarticular infections, para-infectious arthritis, and JIA). Easily accessible biomarkers may aid in diagnosing CRMO. Further studies testing biomarkers in larger unrelated cohorts are warranted.

Details

Original languageEnglish
Article number256
JournalFrontiers in pediatrics
Volume5
Publication statusPublished - 1 Dec 2017
Peer-reviewedYes

Keywords

Keywords

  • Autoinflammation, Biomarker, Chronic nonbacterial osteomyelitis, Chronic recurrent multifocal osteomyelitis, Diagnosis, Inflammation