Anti carbamylated protein antibodies as a diagnostic marker in patients with rheumatoid arthritis and its association with disease activity

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magda Medhat Awad El debsy ◽  
Mervat Mohammed Abdul Hakim ◽  
Henaz Farouk Khaled ◽  
Hala Mohamed Abd El Sabour Sabbah
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Plasma Levels ◽  
Significant Positive Correlation ◽  
Diagnostic Marker ◽  
Complete Blood Count ◽  
Control Group ◽  
Positive Correlation ◽  
Larsen Score ◽  
Function Tests

Abstract Background Despite the diagnostic contribution of anti-citrullinated protein( anti-CCP) antibody and rheumatoid factor (RF), approximately one-third of patients with rheumatoid arthritis (RA) remain seronegative .Anti-carbamylated protein (Anti-Carp) antibodies have been attracting increasing attention as a new diagnostic marker of RA. Objective evaluate levels of anti-carp antibodies in RA patients in order to detect its role as a diagnostic marker and its possible association with disease activity and severity. Methods This study included thirty adult patients with clinical evidence of rheumatoid arthritis and thirty healthy matched age and sex as controls. All underwent history taking, clinical examination, assessment of disease activity with modified Disease Activity28 (DAS28), Laboratory investigations including Complete blood count (CBC), erythrocytes sedimentation rate (ESR), C-Reactive Protein (CRP), Liver function tests, Kidney function tests, Serum uric acid, RF, anti CCP Ab, anti-Carp Ab and radiographic Assessment with Larsen score. Results Plasma levels of anti-Carp Ab were significantly higher in patients than control group (p > 0,001) with sensitivity of 73.33% and specificity of 100%.it showed significant positive correlation with CRP (r = 0.37 )(p < 0.05) as a marker of activity of RA and also there was significant positive correlation with RF and ACPA (r = 0.45)(r = 0.48) (p < 0.05) respectively as a diagnostic marker for RA. Plasma levels of anti-Carp Ab were higher in patients with more joints damage and erosions as assessed by Larsen radiological score as there was a highly significant correlation between Larsen score and serum Anti-Carp(r = 0.61)(p < 0.001).. Conclusion serum Anti–Carp antibody level was higher in RA patients which serve as a diagnostic marker for RA, also its significant correlation with CRP and Larsen score may serve as a marker for disease progression and severity.

scholarly journals POS0549 FUNCTIONAL IMPACT OF FOREFOOT INVOLVEMENT IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 509.1-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
W. Triki ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Significant Positive Correlation ◽  
Foot Deformities ◽  
X Rays ◽  
Functional Impact ◽  
Positive Correlation ◽  
Larsen Score ◽  
The Mean ◽  
Hands And Feet

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects small joints of the hands and feet. Foot deformities may affect the patient’s gait, thus compromising their daily activities and autonomy.Objectives:The aim of this study was to analyze its functional impact.Methods:We conducted a cross-sectional study including patients diagnosed with RA according to the ACR/EULAR 2010 criteria. Demographic variables, Foot Function Index (FFI), and Health Assessment Questionnaire (HAQ) scores were analyzed. We collected data on the following clinical variables: The pain Visual Analog Scale (VAS), forefoot deformities, erythrocyte sedimentation rate (ESR), and Disease Activity Score 28 (DAS28). All patients had feet X-rays and the Larsen score was calculated. A blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer performed ultrasonography (US) of MTP joints. Synovitis was defined as an abnormal hypoechoic synovial tissue within the capsule that is not displaceable and poorly compressible and that may exhibit Doppler signals. The composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:We included 31 patients (25 men and six women) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. The mean ESR and DAS28 ESR were 33±26 mm [5-102] and 3.8±1.5 [0.6-7], respectively. Twenty-nine percent of patients had a high disease activity.Metatarsalgia was reported by 54.8% of patients with a mean VAS of 4.5±3.7 [0-9]. Forefoot deformities were noted in 42% of patients: round forefoot in 13% of cases, triangular forefoot in 29% of cases, hallux valgus in 29% of cases, Quintus varus in 29% of cases, and claw toes in 13% of cases. Corns and calluses were noted in 42% and 29% of cases respectively.X-rays showed abnormalities in 75% of patients. The mean Larsen score was 9.8±6.2 [0-28].US showed synovitis in 46.3% of MTP1, in 53.7% of MTP2, in 48.3% of MTP3, in 42.6% of MTP4, and in 37% of MTP5 joints. Doppler signal was detected in 5.6% of MTP1 and MTP2, and in 3.7% of MTP3, MTP4, and MTP5 joints. The mean US score was 5.3±4.3 [0-15].The mean FFI was 66.5%. Mean rates of pain, difficulty, and disability were 89.5%, 40%, and 70% respectively. The mean HAQ score was 0.5±0.5 [0-2]. Severe disability was noted in 20% of patients.A significant positive correlation was noted between FFI and, Larsen score (r=0.214, p=0.014) and US score (r=0.420, p=0.021). A significant positive correlation was also noted between HAQ score and, foot pain VAS (r=0.555, p=0.009).Conclusion:Foot involvement is frequently seen in RA. This condition may affect patients’ autonomy. Early diagnosis and appropriate treatment are necessary in order to preserve the quality of life.Disclosure of Interests:None declared

scholarly journals AB0207 CLINICAL IMPACT OF ANTI-CARP ANTIBODIES IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1403.1-1404
Author(s):  
M. Markovic ◽  
B. Glisic ◽  
M. Petronijevic
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Status ◽  
Joint Damage ◽  
Control Group ◽  
Antibody Concentration ◽  
Open Label ◽  
Positive Correlation ◽  
Number Of Patients ◽  
Peptide Antibodies

Background:Antibodies directed against carbamylated proteins (anti-CarP) have been recently introduced for the first time as a new biomarker in rheumatoid arthritis (RA) (1). Their presence is predictive for the development of RA (2). Anti-CarP antibodies are associated with the development of more severe forms of the disease in overall and anti-citrullinated peptide antibodies negative population of patients with RA (3). In the literature is still current the research which associate these antibodies with disease activity and functional status of patients.Objectives:This study investigated the incidence of anti-CarP positive findings in patients with RA on synthetic and biologic disease-modifying therapy (DMT) and the relationship between anti-CarP antibody status and both disability and disease activity.Methods:It was an open-label, observational, cross-sectional study. The trial included 70 patients with RA diagnosed on the basis of ACR 1987 and ACR / EULAR 2010 criteria, on treatment with synthetic and biological DMT, who attended the Clinic of Rheumatology, Military Medical Academy, from September to December 2018.The control group consisted of 18 healthy individuals. After approval of the institutional Ethical Committee and after patients have signed Informed Consent,the study was conducted. Disease activity score (DAS28) was determined for the assessment of RA activity, and the assessment of patients’ functional ability was performed using the Health assessment questionnaire disability index (HAQ-DI). Concentration of anti-CarP antibodies was determined by commercial ELISA anti-CarP quantitative sandwich immunoassay. The methods of descriptive and analytical statistics were used in statistical data processing.Results:Based on the cut-off value (5.9 ng / ml), no one in the control group had positive anti-CarP antibodies, while 34.7% of the subjects with RA were positive. The positive correlation was found between anti-CarP antibody concentration and DAS28 in all RA patients (p = 0.0003; Pearson r = 0.4829). The positive correlation was also found between anti-CarP antibody concentration and HAQ-DI in all RA patients (p = 0.0003; Pearson r = 0.4253).Conclusion:Anti-CarP antibodies were present in a significant number of patients with RA. This study demonstrated that patients with RA with higher concentrations of anti-CarP antibodies have higher disease activity and impaired functional status. It is undisputed that further and larger studies are needed to better determine the clinical significance of these antibodies.References:[1]Shi J, Knevel R et al. Autoantibodies recognizing carbamylated proteins are present in sera of patients with rheumatoid arthritis and predict joint damage. Proc Natl AcadSci U S A. 2011 Oct 18;108(42):17372-7.[2]Yee A, Webb T et al. Anti-CarP antibodies as promising marker to measure joint damage and disease activity in patients with rheumatoid arthritis. Immunol Res. 2015 Feb;61(1-2):24-30.[3]Brink M, Verheul MK et al. Anti-carbamylated protein antibodies in thepresymptomatic phase of rheumatoid arthritis, their relationship with multiple anticitrulline peptide antibodies and association with radiological damage. Arthritis Res Ther. 2015 Feb 7;17:25.Graphs 1 and 2.Correlation of anti-CarP antibody concentration with DAS28 and HAQ-DI in all RA patientsDisclosure of Interests:None declared

scholarly journals Disorder Activity of Some Enzymes Plays an Important Role in Pathological Mechanism of Rheumatoid Arthritis Disease

2015 ◽  
Vol 12 (3) ◽  
pp. 572-581
Author(s):  
Baghdad Science Journal
Keyword(s):  
Rheumatoid Arthritis ◽  
Negative Correlation ◽  
Significant Positive Correlation ◽  
Significant Negative Correlation ◽  
Control Group ◽  
Iron Level ◽  
Sod Activity ◽  
Positive Correlation ◽  
Pathological Mechanism ◽  
Cox 2

The aim of this research to show the role of some enzymes in pathological mechanism of rheumatoid arthritis (RA) disease. Sixty patients with RA and matched number of apparently healthy volunteers were included in the study. Spectrophotometric methods were used to determine Peroxy nitrite (ONOO), Nitric oxide (NO), Nitric oxide synthase activity (NOS) cycloxygenase-2 activity (COX-2), glutathione peroxidase (GPX) activity and superoxide dismutase (SOD) activity in serum of both groups. Colorimetric assay kits were used to determine Iron. Rheumatoid factor (RF) was determined using Imuno-Latex kit. ONOO, NO levels, and NOS activity were significantly higher in the patients compared to the control group. Conversely, Iron level, SOD activity and GPX activity were significantly lower in the patients compared to the control. In patients group, RF has significant positive correlation with COX-2, NOS activity and NO level while; it has significant negative correlation with Iron level. ONOO level has significant positive correlation with NO level, NOS activity and COX-2 activity while has significant negative correlation with Iron and SOD activity. NOS activity and NO level have significant positive correlation with COX-2 activity while, they have negative correlation with Iron. Iron has significant negative correlation with COX-2 activity. In control group, COX-2 has significant positive correlation with NOS activity and ONOO level. GPX has significant positive correlation with SOD and Iron. In conclusion: disorder activity of COX-2, NOS, SOD and GPX enzymes play important role in the pathological mechanism of rheumatoid arthritis and they linked with a decreased level of serum iron

Clinical Impact of Interferon-γ in Anti-Citrullinated Protein Antibody-Positive Rheumatoid Arthritis

2020 ◽  
Author(s):  
Kijun Lee ◽  
Hong Ki Min ◽  
Seong-Hee Ko ◽  
Sang-Heon Lee ◽  
Hae-Rim Kim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Immune Response ◽  
T Cells ◽  
Disease Activity ◽  
Plasma Levels ◽  
Control Group ◽  
Clinical Biomarkers ◽  
Reduction Group ◽  
Ifn Γ ◽  
Citrullinated Protein

Abstract Background: CD4+ T cells are crucial for the pathogenesis of rheumatoid arthritis (RA). The roles of gene overexpression in CD4+ T cells and the predictive roles of Th1- and Th17-related cytokines have not been clearly defined in patients with RA. Here, we investigated gene expression levels in CD4+ T cells in methotrexate (MTX)-naïve early RA (eRA) and evaluated changes in CD4+ T-cell-related cytokines during eRA. Methods: Patients with anti-citrullinated protein antibody (ACPA)-positive MTX-naïve eRA were recruited. Patients with osteoarthritis were evaluated as controls. Microarray analysis was used to identify overexpressed genes in CD4+ T cells, and reverse transcription quantitative polymerase chain reaction was used to validate the identified genes. Plasma cytokine levels were measured, and correlations with disease activity were assessed.Results: Thirty-four genes showed overexpression in CD4+ T cells from patients with ACPA-positive MTX-naïve eRA compared with controls. Nineteen were related to interferon (IFN)-γ, and nine were related to interleukin (IL)-17A; five were related to both IFN-γ and IL-17A. Plasma levels of five cytokines were elevated in the ACPA-positive MTX-naïve eRA group compared with those in the control group, and C-X-C motif chemokine ligand 10 was significantly elevated in the ACPA-positive MTX-naïve eRA group compared with that in the established active RA and OA groups. In established RA with low disease activity, the drug-free remission group/drug reduction group showed significantly lower IFN-γ and IL-17A levels than the drug maintenance group and relapse after drug reduction group. Conclusion: Our T2 research of IFN-γ emphasized that, not only the Th17 immune response, but the Th1 immune response is also very important for the RA pathogenesis. Concurrent increase in IFN-γ and IL-17 were observed in active stage of ACPA-positive MTX-naïve eRA, and the plasma levels of them could be useful for new clinical biomarkers before and/or after treatment of RA.

scholarly journals THU0536 ASSOCIATION BETWEEN OVERWEIGHT/OBESITY AND DISEASE ACTIVITY ON BONE SCINTIGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 507.2-507
Author(s):  
S. M. Lee ◽  
J. W. Lee
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Bone Scintigraphy ◽  
Significant Positive Correlation ◽  
Blood Pool ◽  
Study Data ◽  
Uptake Ratio ◽  
Positive Correlation ◽  
Multi Center Study ◽  
Baseline Bmi

Background:In previous studies, obesity is highly prevalent in patients diagnosed with rheumatoid arthritis and it is positively associated with disease activity1. Although Tc-99m-labeled bone scintigraphy has been widely performed to evaluate the disease activity of the joints involved in this disease2; the effect of body mass index (BMI) on the results of bone scintigraphy is yet to be accessed.Objectives:In the present study, we evaluated the relationship between BMI and uptake intensity of the joints that was measured using bone scintigraphy in patients with rheumatoid arthritis.Methods:A total of 80 patients (21 men and 59 women; mean age 56±14 years) with rheumatoid arthritis who underwent Tc-99m methylene diphosphonate bone scintigraphy before treatment were enrolled in this study. Data were collected for baseline BMI and disease activity score for the 28 joints using erythrocyte sedimentation rate (DAS28-ESR) of these patients. Uptake intensity of these 28 joints was automatically measured for each patient using an in-house software, expressed as joint uptake-to-background normal bone uptake ratio (joint uptake ratio). The correlation of BMI with DAS28-ESR and joint uptake ratio on bone scintigraphy was assessed.Results:Mean BMI of the enrolled patients was 24.4±3.7 kg/m2and 50 patients (62.5%) were classified as overweight/obesity. BMI was significantly positively correlated with the sum of 28 joint uptake ratios on bone scintigraphy (p=0.021, correlation coefficient=0.358) as well as DAS28-ESR (p=0.030). Patients with overweight/obesity (39.2±9.5) had significantly higher values of the sum of 28 joint uptake ratios than the other patients (33.9±9.5; p=0.025). In correlation analysis with each joint uptake ratio of 28 joints, BMI more significantly positively correlated with uptake ratios of shoulder, elbow, and knee joints than those in wrist and hand joints. In subgroup analysis of patients having low (DAS28-ESR ≤3.2) and high (DAS28-ESR >3.2) disease activity, BMI still showed significant positive correlation with the sum of 28 joint uptake ratio on bone scintigraphy in both subgroups (p<0.05 for all).Conclusion:The Baseline BMI in patients with rheumatoid arthritis had significant positive correlation with joint uptake intensity measured on bone scintigraphy, especially for large joints. The results of our study might provide an evidence that supports an association between BMI and disease activity of rheumatoid arthritis.References:[1]de Resende Guimaraes MFB, Rodrigues CEM, Gomes KWP, et al. High prevalence of obesity in rheumatoid arthritis: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study. Adv Rheumatol 2019;59:44.[2]Kim JY, Choi YY, Kim CW, et al. Bone scintigraphy in the diagnosis of rheumatoid arthritis: is there additional value of bone scintigraphy with blood pool phase over conventional bone scintigraphy? J Korean Med Sci 2016;31:502-9.Acknowledgments:Research relating to this abstract was funded by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: NRF-2018R1C1B5040061).Disclosure of Interests:None declared

Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatih Öner Kaya ◽  
Yeşim Ceylaner ◽  
Belkız Öngen İpek ◽  
Zeynep Güneş Özünal ◽  
Gülbüz Sezgin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Volunteers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Control Group ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Das 28 ◽  
Tnf Α

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

Evaluation of Toll-like Receptor 2 Gene Expression in Rheumatoid Arthritis and Correlation with the Disease Activity

2019 ◽  
Vol 13 (2) ◽  
pp. 140-148
Author(s):  
Mai Nasser ◽  
Noha M. Hazem ◽  
Amany Atwa ◽  
Amina Baiomy
Keyword(s):  
Rheumatoid Arthritis ◽  
Gene Expression ◽  
Autoimmune Diseases ◽  
Disease Activity ◽  
Mrna Expression ◽  
Disease Activity Score ◽  
Activity Score ◽  
Tlr2 Expression ◽  
Positive Correlation ◽  
Tlr2 Mrna

Background: Rheumatoid Arthritis (RA) is an autoimmune, chronic, and systematic disease. It affects joints and bones. The exact etiology of RA is still unclear. Varied genetic and environmental factors have been associated with the increased risk for RA. Overactivation of Toll-Like Receptors (TLRs) could initiate the development of autoimmune diseases including RA. Objective: The aim of the study was to evaluate TLR2 gene expression in rheumatoid arthritis patients and investigate its correlation with the disease activity. Materials and Methods: This study included 60 patients and 20 healthy individuals. The patients were diagnosed with RA according to the 2010 American College of Rheumatology/ European League Against Rheumatism criteria (ACR/EULAR). All included subjects did not have any joint disorders and /or autoimmune diseases. RA disease activity was determined by the disease activity score of 28 joints. Whole blood was collected from all participants. Total RNA extraction was done. TLR2 mRNA expression was assessed by reverse transcription-PCR (RT-PCR). Results: TLR2 mRNA expression was found to be significantly higher in RA patients compared to healthy controls. Also, a strong positive correlation was found between TLR2 expression level and the disease activity score. A non significant positive correlation was found between TLR2 expression and serum Rheumatoid Factor (RF) level. Conclusion: TLR2 pathway may have an important role in RA pathogenesis and could be a new biomarker for diagnosis and monitoring disease activity.

scholarly journals FRI0094 SIGNIFICANT IMPROVEMENT OF NT-PROBNP LEVELS IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH TOCILIZUMAB AND TOFACITINIB

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 625.2-626
Author(s):  
H. Gerasimova ◽  
T. Popkova ◽  
I. Kirillova ◽  
M. Cherkasova ◽  
A. Martynova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cardiovascular Death ◽  
Control Group ◽  
Activity Levels ◽  
Das 28 ◽  
Interleukin 6 Receptor ◽  
Inflammatory Drugs ◽  
Roche Diagnostics

Background:N-terminal pro-brain natriuretic peptide (NT-proBNP) is a recognized predictor of congestive heart failure (CHF) and cardiovascular death. Rheumatoid arthritis (RA) patients (pts) were shown to have higher NT-proBNP concentrations than in general population, but it remains unclear, whether NT-proBNP levels are related to RA duration, activity or treatment.Objectives:To investigate the effect of interleukin 6 receptor inhibitor - tocilizumab (TCZ) and JAK inhibitor - tofacitinib (TOFA) on NT-proBNP levels in RA pts during a 12-month (m) follow-up period.Methods:The study enrolled 60pts (50women/10men) with the lack of efficacy/resistance and/or intolerance of basic anti-inflammatory drugs (DMARDs); median age was 55[42;61] years, median disease duration 55[29;120]m, with moderate to high activity (DAS28-5,1[4,6;6,1], serum positivity for rheumatoid factor (RF)(85%)/ anti-cyclic citrullinated peptide antibodies (ACCP)(80%). The study did not include RA pts with CHF and clinically overt cardiovascular disease (CVD). Twenty nine RA pts received TCZ(8mg/kg) every 4 weeks: 61% received TCZ in combination with methotrexate (MTX), 35% - with low-dose glucocorticoids (GCs). Thirty one RA pts were prescribed oral TOFA at 5 mg BID with dose escalation to 10 mg BID in 8 (26%)pts. TOFA was used in combination with MTX in 90% pts, with GCs – in 29% pts. Pts treated with TCZ and TOFA were comparable in terms of age, sex, body mass index. RA activity rates (DAS28, SDAI, ESR, CRP) were higher in pts on TCZ -therapy compared with pts treated with TOFA. Echocardiography data and NT-proBNP levels using electrochemiluminescence method Elecsys proBNP II (Roche Diagnostics, Switzerland) were obtained at baseline and after 12m.Results:Significant positive changes in major disease activity, clinical and laboratory parameters were found in RA pts after 12 m of TCZ infusion and TOFA intake: remission (DAS28<2,6) was achieved in 54% and 39% pts, low activity levels (DAS28<3,2) – in 46% and 51% pts, respectively.The NT-proBNP levels were significantly higher in RA pts than in the control group (median 69,1 (37,9;105,8) pg/mL vs 55,3 (36,6;67,3) pg/mL,p<0.05).Six pts (10%) (three in each pts group) had NT-proBNP levels over 125pg/ml, but were asymptomatic and had unremarkable echocardiography.There was a good correlation between NT-proBNP level at baseline with age (r=0,55,p<0,001), SDAI (r=0,5, h=0,01), ACCP (r=0,23,p=0,01).Decrease of median NT-proBNP levels was documented after 12m of TCZ therapy (81,5[43,0;102,0]vs41,6[25,4;64,2]pg/ml (p<0,01) and after 12m TOFA therapy (66,1[30,5;105,0]vs16,8 [5,0;81,0]pg/ml,p=0,001).After 12m of TCZ correlations of ΔNT-proBNP were established with ΔESR (R=0,43;p<0,05], ΔСRP (R=0,46;p<0,05], ΔEe left ventricle (LV) (r=0,88,p=0,03).In the group of pts treated with TOFA ΔNT-proBNP level significantly correlated with the percentage change in DAS 28 (r=0,41,p=0,038), there was no direct correlation with changes in the parameters of the LV diastolic function.Conclusion:TCZ and TOFA treatment for 12 m reduced NT-proBNP levels in RA pts without clinically manifest CVD and CHF. Falling NT-proBNP concentrations are associated with positive dynamics of RA activity (DAS 28) and inflammatory markers (CRP, ESR), therefore allowing to suggest that increased NT-proBNP levels should be considered as a component of disease activity. Correlation between ΔNT-proBNP and ΔEeLF may be indicative as possible impact of these biomarkers on the LV diastolic function’s development in RA pts.Disclosure of Interests:None declared

Increased plasma kynurenine and its relationship to neopterin and tryptophan in Tourette's syndrome

1996 ◽  
Vol 26 (4) ◽  
pp. 857-862 ◽  
Author(s):  
H. Rickards ◽  
S. M. Dursun ◽  
G. Farrar ◽  
T. Betts ◽  
J. A. Corbett ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Negative Correlation ◽  
Plasma Levels ◽  
Significant Positive Correlation ◽  
Significant Negative Correlation ◽  
Healthy Controls ◽  
Positive Correlation ◽  
Control Value ◽  
Cellular Immune ◽  
Patient Value

SynopsisFasting plasma levels of tryptophan, kynurenine and the pteridines, neopterin and tetrahydrobiopterin were measured in seven patients with Gilles de la Tourette syndrome (GTS) and 10 healthy controls. Plasma kynurenine was significantly elevated in the GTS patients. The lowest patient value was higher than the highest control value. Values for tryptophan, neopterin and tetrahydrobiopterin were similar in TS patients and controls. However, in TS patients only, there was a significant negative correlation between tryptophan and neopterin and a significant positive correlation between kynurenine and neopterin when controlling for tryptophan. This finding indicates that activation of cellular immune processes is a possible explanation for the rise in plasma kynurenine.

scholarly journals POS1405 OPTICAL SPECTRAL TRANSMISSION (HANDSCAN) IN PATIENTS WITH PSORIATIC ARTHRITIS: FIRST DATA ON DIAGNOSTIC VALUE AND ASSOCIATIONS WITH CLINICAL AND ULTRASOUND DISEASE ACTIVITY MARKERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 985.1-985
Author(s):  
K. Triantafyllias ◽  
S. Liverakos ◽  
C. Noack ◽  
A. Schwarting
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Power Doppler ◽  
Patient Characteristics ◽  
Diagnostic Value ◽  
Control Group ◽  
Spectral Transmission ◽  
Grey Scale ◽  
Assessment Of Disease Activity

Background:Valid assessment of disease activity leads to improvement of long-term outcomes in patients with inflammatory arthritis (1). Optical spectral transmission (OST) is a modern diagnostic tool able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with rheumatoid arthritis (RA) (commercial device: HandScan – Demcon/Hemics, The Netherlands) (2). Even though an increasing number of studies have evaluated diagnostic value of this new technology in RA patients (2,3), no data exist regarding psoriatic arthritis (PsA).Objectives:To examine for the first time the diagnostic value of OST in detecting inflammation in patients with PsA and to evaluate its relationship with disease activity markers and various epidemiological and anthropometric patient characteristics.Methods:OST-Measurements were performed in a group of PsA patients and a group of healthy controls. The difference between OST in the two groups was statistically examined and relationships of OST with clinical (tender / swollen joint counts, disease activity on a visual analogue scale) and serological disease activity markers were evaluated. Moreover, joint ultrasound (US) examinations were performed in a subgroup of PsA patients and OST associations with a Power Doppler- and a Grey Scale-US score were examined. Finally, relationships of OST with various anthropometric and epidemiologic parameters (BMI, hand-size, gender, age) were assessed.Results:We recruited 49 PsA patients [65.3% female; mean age 53.3 years (± 11.8 SD)] and 114 control subjects [77.2% female; mean age 46 years (± 12.8 SD)]. OST was statistically significantly higher in the patient group, compared to the control group [14.95 (12.04 - 17.18, IQR) vs. 10.31 (7.84 – 13.79, IQR); p<0.001]. OST correlated moderately-strongly with both examined US scores (Power Doppler-score: r = 0.5; p = 0.026 and Grey Scale-score: r = 0.52; p = 0.028). Moreover, OST showed a moderate, statistically significant association with C-reactive protein (CRP) (r = 0,298; p = 0,037). Finally, males had significantly higher OST values than females and OST associated moderately-weakly with body mass index (BMI) in the control group (rho = 0.24; p< 0.001).Conclusion:This is the first report of a possible diagnostic value of OST in patients with PsA. OST correlated with ultrasound and serological activity markers and may thus prove to be a useful tool of disease activity assessment, next to well established diagnostic modalities, such as the joint US. Correlations of OST with patient characteristics implicate the need to take also anthropometric and epidemiological patient characteristics into account when interprenting OST results in order to avoid confounding.References:[1]Katchamart W, et al. Systematic monitoring of disease activity using an outcome measure improves outcomes in rheumatoid arthritis. J Rheumatol 2010;37:1411–1415.[2]Triantafyllias, et al. Diagnostic value of optical spectral transmission in rheumatoid arthritis: associations with clinical characteristics and comparison with joint ultrasonography. J Rheumatol 2020 1;47(9):1314-1322.[3]Onna M Van, et al. Assessment of disease activity in patients with rheumatoid arthritis using optical spectral transmission measurements, a non-invasive imaging technique. Ann Rheum Dis 2016;75:511–518.Disclosure of Interests:Konstantinos Triantafyllias Speakers bureau: Pfizer, Novartis, Janssen, Chugai, Stefanie Liverakos: None declared, Claudia Noack: None declared, Andreas Schwarting: None declared

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