Journal of Neuroimmunology 278 (2015) 136

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Letter to Editor Evaluation of pentraxin-3 in POEMS syndrome Keywords: POEMS Pentraxin 3 Contributing factors

In conclusion, the explanation of above concerns will certainly provide the clearer information for the readers. Conflict of interest The authors declare that there is no conflict of interest. References

Dear Editor We have read with great interest the article by Briani et al. entitled with “Pentraxin-3 and VEGF in POEMS syndrome: A 2-year longitudinal study” (Briani et al., 2014). They have suggested that they could not exclude that pentraxin-3 (PTX3), a biomarker reflecting vascular injury and repair, might be useful in polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome patients to identify ongoing vascular events. However, there are some points that need to be clarified. PTX3 is an acute phase protein and produced in response to inflammatory conditions in vivo (Yaman et al., 2013). There are various conditions which likely affect PTX3 levels. Several inflammatory or infectious diseases such as several types of vasculitis, rheumatologic diseases, chronic kidney diseases, cardiovascular diseases, immunological disorders, pneumonia, asthma, chronic obstructive pulmonary disease, ulcerative colitis and Crohn's disease (Agilli et al., 2014; Bonacina et al., 2013). In this regard, simple laboratory tests such as complete blood count, C reactive protein, routine biochemistry tests and erythrocyte sedimentation rate were assigned; a robust study population could be designed. Previous studies suggested that angiotensin converting enzyme inhibitors and statins could alter serum PTX3 levels in addition to stated medicine (Iwata et al., 2012). Besides, dietary food supplements such as vitamin D, vitamin A, omega-3 fatty acid, and vitamin E could influence PTX3 levels (Rosjo et al., 2014). Obesity is another confounding factor for PTX3 measurement. Witasp et al. (2014) reported that PTX3 levels positively correlate with obesity. Therefore, these contributing factors should be stated to provide meaningful data. 0165-5728/© 2014 Elsevier B.V. All rights reserved.

Agilli, M., Aydin, F.N., Cayci, T., Kurt, Y.G., 2014. Pentraxin 3 (PTX3) plasma levels and carotid intima media thickness progression in the general population: a methodological approach. Nutr. Metab. Cardiovasc. Dis. 24, e38–e39. Bonacina, F., Baragetti, A., Catapano, A.L., Norata, G.D., 2013. Long pentraxin 3: experimental and clinical relevance in cardiovascular diseases. Mediat. Inflamm. 2013, 725102. Briani, C., Torre, C.D., Lessi, F., Cavallaro, T., Scarlato, M., Ferrari, S., Campagnolo, M., Lucchetta, M., Cabrini, I., Morbin, M., Lauria, G., Adami, F., Manfredi, A.A., 2014. Pentraxin-3 and VEGF in POEMS syndrome: a 2-year longitudinal study. J. Neuroimmunol. 277, 189–192. Iwata, A., Miura, S., Tanaka, T., Ike, A., Sugihara, M., Nishikawa, H., Kawamura, A., Saku, K., 2012. Plasma pentraxin-3 levels are associated with coronary plaque vulnerability and are decreased by statin. Coron. Artery Dis. 23, 315–321. Rosjo, E., Myhr, K.M., Loken-Amsrud, K.I., Bakke, S.J., Beiske, A.G., Bjerve, K.S., Hovdal, H., Lilleas, F., Midgard, R., Pedersen, T., Benth, J.S., Torkildsen, O., Wergeland, S., Michelsen, A.E., Aukrust, P., Ueland, T., Holmoy, T., 2014. Increasing serum levels of vitamin A, D and E are associated with alterations of different inflammation markers in patients with multiple sclerosis. J. Neuroimmunol. 271, 60–65. Witasp, A., Carrero, J.J., Michaelsson, K., Ahlstrom, H., Kullberg, J., Adamsson, V., Riserus, U., Larsson, A., Helmersson-Karlqvist, J., Lind, L., Stenvinkel, P., Arnlov, J., 2014. Inflammatory biomarker pentraxin 3 (PTX3) in relation to obesity, body fat depots and weight loss. Obesity (Silver Spring) 22, 1373–1379. Yaman, H., Cakir, E., Akgul, E.O., Aydin, I., Onguru, O., Cayci, T., Kurt, Y.G., Agilli, M., Aydin, F.N., Gulec, M., Altinel, O., Isbilir, S., Ersoz, N., Yasar, M., Turker, T., Bilgi, C., Erbil, K.M., 2013. Pentraxin 3 as a potential biomarker of acetaminophen-induced liver injury. Exp. Toxicol. Pathol. 65, 147–151.

Mehmet Agilli Department of Biochemistry, Agri Military Hospital, Agri, Turkey Corresponding author. E-mail address: [email protected] Fevzi Nuri Aydin Department of Biochemistry, Sirnak Military Hospital, Sirnak, Turkey 10 December 2014

Evaluation of pentraxin-3 in POEMS syndrome.

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