Gelsolin (Gsn), an actin-binding protein implicated in cytoskeletal remodeling and the regulation of inflammation, has emerged as a potential biomarker for immune-mediated and inflammatory diseases. This prospective case-control study aimed to evaluate serum Gsn levels in children diagnosed with juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) and to assess its potential utility in differentiating between these two pediatric rheumatic disorders. The study involved 90 children aged 2-18 years: 30 with JIA, 30 with FMF, and 30 age-matched healthy controls. Serum Gsn concentrations were quantified using enzyme-linked immunosorbent assay (ELISA), and both clinical and laboratory parameters were analyzed. Mean serum Gsn levels were highest in the FMF group (28.8 ± 2.5), followed by the JIA group (25.7 ± 2.8) and healthy controls (23.9 ± 2.7), with significant differences observed among the groups (p < 0.001). Gsn levels were significantly elevated in children with FMF compared to those with JIA, and receiver operating characteristic (ROC) analysis demonstrated strong discriminatory performance, with an area under the curve (AUC) of 0.82. Logistic regression analysis identified serum Gsn, aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) as independent predictors for distinguishing FMF from JIA. Each unit increase in Gsn was associated with increased odds of an FMF diagnosis (odds ratio OR: 2.89, 95% confidence interval CI: 1.58-5.29, p = 0.001). These findings suggest that serum Gsn may serve as a valuable biomarker in pediatric inflammatory rheumatic diseases, particularly in differentiating FMF from JIA. Further large-scale prospective studies are necessary to validate its diagnostic effectiveness.
Dişçi et al. (Mon,) studied this question.