E- Selectin as a Predictor for Overt and Subclinical Cardiovascular Riskin Patients with Juvenile Idiopathic Arthritis

Abstract Background The risk of cardiovascular disorders (CVD) was described in adult patients with systemic juvenile idiopathic arthritis (SJIA) as a part of the systemic activity of the disease. Subclinical cardiovascular risk and early atherogenesis were not broadly studied in children. Objectives This work aims to evaluate soluble E-selectin level as a marker of early endothelial injury, as a predictor for early or subclinical CVD among patients with juvenile idiopathic arthritis (JIA). Patients and Methods This cross-sectional study with nested follow up was conducted in the Pediatric Allergy, Immunology and Rheumatology Unit, Children’s Hospital, Ain Shams University on 57 children and adolescents diagnosed as JIA. They were 6 to 16 years old, including 26/57 (45.6%) males and 31/57 (54.4%) females, and 30 matched healthy controls, during the period from September 2021 to September 2022. Patients were enrolled consecutively during activity and remission status of the disease, determined according to juvenile arthritis disease activity score (JADAS). Serum level of endothelium (E)-selectin was measured using ELISA technique. Patients with active JIA were followed till complete remission. Results Serum levels of E-selectin showed higher estimates among JIA patients during activity and remission than in the healthy control group (p < 0.001); whereas there was no significant difference in E-selectin level among the studied categories of JIA (P > 0.05). Conclusion The observed significantly elevated soluble E-selectin levels among pediatric patients with JIA, denotes the possibility of early atherogenesis or subclinical CVD. Correlation with other cardiac evaluation tools in patients with JIA is recommended.