Lectin pathway factors in patients suffering from juvenile idiopathic arthritis

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Both complement activation and certain infections (including those withYersiniasp.) may contribute to the pathogenesis of juvenile idiopathic arthritis (JIA). We investigated factors specific for the lectin pathway of complement: mannose-binding lectin (MBL), ficolins and MBL-associated serine protease-2 (MASP-2), in 144 patients and 98 controls. One hundred and six patients had oligoarticular disease and 38 had polyarticular disease. In 51 patients (out of 133 tested),Yersinia-reactive antibodies were found (JIA Ye+group). MBL deficiency was significantly more frequent in the JIA Ye+group than in patients withoutYersinia-reactive antibodies or in controls. Median serum ficolin-2 level was significantly lower (and proportion of values deemed ficolin-2 insufficient greater) in JIA patients irrespective of theirYersiniaantibody status. The minority (C) allele at - 64 of theFCN2gene was less frequent among JIA patients than among control subjects. No differences were found in the frequency ofFCN3gene +1637delC orMASP2+359 A > G mutations nor for median values of serum ficolin-1, ficolin-3 or MASP-2. However, high levels of serum ficolin-3 were under-represented in patients, in contrast to MBL. MBL, ficolin-1, ficolin-2, ficolin-3 and MASP-2 were also readily detectable in synovial fluid samples but at a considerably lower level than in serum. Our findings suggest a possible role for the lectin pathway in the pathogenesis of JIA, perhaps secondary to a role in host defence, and indicate that investigations on the specificity of lectin pathway recognition molecules towards specific infectious agents in JIA might be fruitful.

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