Academic Journal
The effect of etanercept therapy on adrenal steroid metabolism in juvenile idiopathic arthritis: a steroid metabolomics approach
| Title: | The effect of etanercept therapy on adrenal steroid metabolism in juvenile idiopathic arthritis: a steroid metabolomics approach |
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| Authors: | Yonatan Butbul Aviel, Ariel Keinan, Michaela F. Hartmann, Stefan A. Wudy, Dov Tiosano |
| Source: | Pediatric Rheumatology Online Journal, Vol 21, Iss 1, Pp 1-9 (2023) |
| Publisher Information: | BMC, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Pediatrics LCC:Diseases of the musculoskeletal system |
| Subject Terms: | Juvenile idiopathic arthritis, Steroid, Metabolomics, GC-MS, Anti-TNFα, Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935 |
| More Details: | Abstract Objective To evaluate the impact of anti-tumor necrosis factor-alpha (TNFα: etanercept [Etanercept ®]) therapy on adrenal activity in juvenile idiopathic arthritis (JIA) . Method Eleven JIA patients aged 12 ± 6.2 years with a disease duration of 6.3 ± 5.2 years were enrolled. They were treated once weekly with etanercept (0.8 mg/kg) for 3 ± 2.8 years. Urine samples for gas chromatography-mass spectrometry steroid hormone analysis were collected before, and 1 and 3 days after etanercept injection and compared to age- and sex-matched healthy controls. Results The levels of 21 of the 31 metabolites were low before etanercept treatment. Those 21 metabolites included 4 C19 steroids (androgens), 5 C C21 steroid hormone intermediates, 10 cortisol metabolites, and 2 corticosterone metabolites. One day after treatment, only 5 of the 21 metabolite levels remained low. They included 2 C19 metabolites, 2 C21 steroid metabolites and 1 cortisol metabolite β –Cortol (β-Cl). Three days after treatment, the only metabolites levels that continued to be low were 2 C19 metabolite, 2 C21 steroid hormone intermediates and 1 cortisol metabolite α-Cortol (a-Cl), while the remaining 15 metabolites had already normalized after 1 day. Dehydroepiandrosterone-sulfate and 17-hydroxypregnenolone metabolite levels were the last ones to recover. Urinary metabolite ratios reflecting cytochrome P450 CYP21A2 (21-hydroxylase) and 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) enzymatic activitieswere lower in JIA patients than in controls, although significant was not reached. Conclusion Almost all of the pre-etanercept treatment cortisol urinary metabolite levels were significantly lower than normal, and almost all rose to normal values by 1 day after treatment. The therapeutic effect of anti-TNFα treatment in JIA may be related to its effect on the restoration of adrenal function and cortisol levels. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1546-0096 |
| Relation: | https://doaj.org/toc/1546-0096 |
| DOI: | 10.1186/s12969-023-00813-y |
| Access URL: | https://doaj.org/article/ab16052cbfc74e84a748f6121263206b |
| Accession Number: | edsdoj.b16052cbfc74e84a748f6121263206b |
| Database: | Directory of Open Access Journals |
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| ISSN: | 15460096 |
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| DOI: | 10.1186/s12969-023-00813-y |
| Published in: | Pediatric Rheumatology Online Journal |
| Language: | English |