scholarly journals AB0096 FCER1G GENE METHYLATION AND MIR-106/MIR-17 AS A NEW POTENTIAL EPIGENETIC MARKERS IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1347.1-1348
Author(s):  
M. Ciesla ◽  
B. Kolarz ◽  
M. Dryglewska ◽  
M. Majdan
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Family Members ◽  
Fc Receptor ◽  
High Disease Activity ◽  
Healthy Controls ◽  
Gene Methylation ◽  
Gamma Chain ◽  
Epigenetic Markers ◽  
Activity Group

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to joints destruction. One of the most important cytokine responsible for this process is interleukin 6 (IL-6). Fc receptor gamma chain (FcRγ), encoded byFCER1Ggene, is responsible for neutrophils activation, phagocytosis, cell surface signaling pathway as well as IL-4, IL-6, IL-10 and tumor necrosis factor production. Epigenetic factors, including DNA methylation and micro-RNAs (miRs) expression regulate the genes expression on transcriptional and post-transcriptional mechanisms. There are miRs responsible for cytokines production, for example GU rich miRs, miR-106b and miR-155 were reported as associated with IL-6 overproduction.Objectives:The aim of our study was to evaluateFCER1Ggene methylation and miR-17 family members as epigenetic markers associated with RA, disease activity and IL-6 expression.Methods:Bioinformatics analysis were applied to select the miRs with a possible target sites in a promoter region ofFCER1Ggene. The MiR-17 family members, including miR-17, miR-93 and miR-106b were selected for investigation.A total of 74 individuals, 50 RA patients, 84% female, aged 53,7±12,3 years (mean±SD) and 24 healthy controls (HC), 87,5% female, aged 53±8,49 years were enrolled. RA patients were selected based on DAS-28 scoring. RA patients with high disease activity (DAS28 >5,1; 58%) and remission (≤2,6; 42%) were included in the analysis. DNA was extracted from a whole blood and miRs were extracted from plasma. Quantitative real-time PCR was use for analyze both methylation and expression levels. In a randomly selected samples (16 from high disease activity group; 9 from remission and 19 from HC) the level of IL-6 in serum was evaluated.Results:Patients with RA in comparison to HC have had a lowerFCER1Gmethylation (0.98 [0.73-1.46] vs 1.96 [1.44-3], p<0.00001; median [interquartile range]) and miR-106b (0.79 [0.49-1.68] vs 1.54 [0.88-2.51], p=0.008) and miR-17 (1.26 [0.41-2.04] vs 2.44 [2.09-3.47], p=0.0001) expressions. No difference in methylation between high and remission RA groups was found. MiR-106b and miR-17 expressions were different between RA patients with high disease activity and remission (p=0.009 and p=0.003, respectively), however a high disease activity group was not different to HC (p=0.82 and p=0.12, respectively). Detailed results are presented in Table 1. A strong correlation between IL-6 levels andFCER1Gmethylation (rs= -0.46) was found.Table 1.Methylation and expression between patients divided by disease activity in compare to controls.High disease activity, n=29Remission, n=21HC, n=24FCER1Gmethylation1.11 [0.83-1.52]0.96 [0.61-1.18]1.96 [1.44-3]miR-106b expression1.36 [0.63-1.76]0.54 [0.19-1.19]1.54 [0.88-2.51]miR-93 expression0.63 [0.49-1.21]0.59 [0.15-1.5]1.03 [0.65-1.38]miR-17 expression1.46 [1.05-2.54]0.34 [0.11-1.26]2.44 [2.09-3.47]Data are given by median [interquartile range]. FCER1G, Fc receptor gamma chain gene; HC, healthy controls; miR, micro-RNA; RA, rheumatoid arthritis patients.Conclusion:FCER1Gmethylation was found as a new epigenetic marker of RA, which is independent of disease activity and may be associated with IL-6 production. Plasma miR-17 and miR-106b can be considered as a novel molecular biomarkers of disease severity in RA.FcRγ may plays a significant role in RA pathogenesis andFCER1Ggene methylation was found as a new, epigenetic and promising marker of RA.References:[1]Németh T, Futosi K, Szabó M, Aradi P, Saito T, Mócsai A, Jakus Z. Importance of Fc Receptor γ-Chain ITAM Tyrosines in Neutrophil Activation and in vivo Autoimmune Arthritis. Front Immunol. 2019 Feb 25;10:252.[2]Cunningham F et al. Ensembl 2019. Nucleic Acids Res. 2019 Jan 8;47(D1):D745-D751.[3]Salvi V, Gianello V, Tiberio L, Sozzani S, Bosisio D. Cytokine Targeting by miRNAs in Autoimmune Diseases. Front Immunol. 2019 Jan 29;10:15.Disclosure of Interests:Marek Ciesla: None declared, Bogdan Kolarz: None declared, Magdalena Dryglewska: None declared, Maria Majdan Consultant of: Roche, Amgen, Speakers bureau: Roche, Amgen

scholarly journals Platelet-To-Lymphocyte Ratio Can Be Used As Marker To Predict Activity And Severity In Moderate And High Disease Activity of Rheumatoid Arthritis: A Retrospective Study

2021 ◽  
Author(s):  
Bilin Chen ◽  
Qing Zhu ◽  
Shu Li ◽  
Yan Ge ◽  
Peijun Wu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Disease Activity ◽  
Roc Analysis ◽  
High Disease Activity ◽  
Regression Analyses ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Activity Group ◽  
Ultrasound Score

Abstract Objective: This study aimed to study and evaluate the value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers to predict the disease activity and severity in patients with rheumatoid arthritis (RA).Methods: A total of 139 inpatients with RA were divided into two groups: moderate activity group (3.2<DAS28-CRP score<5.1) and high activity group (≥5.1). The correlation of routine hematological indices with DAS28 and joint ultrasound score (gray-scale ultrasound score, GS-US; power Doppler ultrasound score, PD-US; total ultrasound score, T-US) were analyzed by Pearson's correlation and logistic regression analyses. Receiver operating characteristics (ROC) analysis was performed to compare the efficacy of blood indices, ESR, or CRP in reflecting the disease activity and severity of RA.Results: The values of PLR, NLR, PD-US, and T-US were significantly different between moderate and high disease activity groups (p<0.001), and PLR was significantly correlated with PD-US and DAS28. Logistic regression analyses showed that PLR was an independent risk factor for disease activity by DAS 28 and joint damage severity by PD-US and T-US. ROC analysis showed that the efficacy of using PLR alone to evaluate the disease activity and joint severity of RA was similar to that of using combined CRP and ESR. The best cut-off value of PLR for predicting high disease activity and high joint severity was determined as 236.6.Conclusions: PLR can be used as a marker to predict activity and severity in patients with moderate and high RA disease activity.

scholarly journals Association between Serum 25-Hydroxyvitamin D Level and Rheumatoid Arthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Xiaomin Cen ◽  
Yuan Liu ◽  
Geng Yin ◽  
Min Yang ◽  
Qibing Xie
Keyword(s):  
Rheumatoid Arthritis ◽  
Complete Remission ◽  
Disease Activity ◽  
Normal Group ◽  
High Disease Activity ◽  
Low Disease Activity ◽  
Hydroxyvitamin D ◽  
Activity Group ◽  
25 Hydroxyvitamin D ◽  
Baseline Characteristics

The objective of this study is to examine and evaluate whether serum 25(OH)D is associated with disease activity in patients with rheumatoid arthritis (RA). Our results suggested that serum 25(OH)D in RA groups has significant lower level (35.99±12.59 nmol/L) than that in the normal groups (54.35±8.20 nmol/L,P<0.05). Based on the DAS28, patients with RA were divided into four subgroups, and no differences were found in the four groups (P>0.05). The 25(OH)D levels in complete remission, low disease activity, middle disease activity, and high disease activity group were32.86±12.26,33.97±13.28,38.41±10.64, and38.94±13.35 nmol/L, respectively. Based on the serum 25(OH)D levels, patients with RA were divided into inadequate group and normal group, and there were no significant differences in baseline characteristics and disease activity in the two groups. Our results showed that serum 25(OH)D levels in the inadequate group are significantly lower than those in the normal group. However, no correlations were found between 25(OH)D levels and disease activity among 116 patients with RA. The present findings will help to understand the association between 25(OH)D and disease activity of RA.

scholarly journals Platelet-to-lymphocyte Ratio can be used as Marker to Predict Activity and Severity in Moderate and High Disease Activity of Rheumatoid Arthritis: A Retrospective Study

2021 ◽  
Author(s):  
Bilin Chen ◽  
Qing Zhu ◽  
Shu Li ◽  
Yan Ge ◽  
Peijun Wu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Disease Activity ◽  
Roc Analysis ◽  
High Disease Activity ◽  
Regression Analyses ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Activity Group ◽  
Ultrasound Score

Abstract Objective: This study aimed to study and evaluate the value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers to predict the disease activity and severity in patients with rheumatoid arthritis (RA).Methods: A total of 139 inpatients with RA were divided into two groups: moderate activity group (3.2<DAS28-CRP score<5.1) and high activity group (≥5.1). The correlation of routine hematological indices with DAS28 and joint ultrasound score (gray-scale ultrasound score, GS-US; power Doppler ultrasound score, PD-US; total ultrasound score, T-US) were analyzed by Pearson's correlation and logistic regression analyses. Receiver operating characteristics (ROC) analysis was performed to compare the efficacy of blood indices, ESR, or CRP in reflecting the disease activity and severity of RA.Results: The values of PLR, NLR, PD-US, and T-US were significantly different between moderate and high disease activity groups (p<0.001), and PLR was significantly correlated with PD-US and DAS28. Logistic regression analyses showed that PLR was an independent risk factor for disease activity by DAS 28 and joint damage severity by PD-US and T-US. ROC analysis showed that the efficacy of using PLR alone to evaluate the disease activity and joint severity of RA was similar to that of using combined CRP and ESR. The best cut-off value of PLR for predicting high disease activity and high joint severity was determined as 236.6.Conclusions: PLR can be used as a marker to predict activity and severity in patients with moderate and high RA disease activity.

Elevated expression of FABP4 is associated with disease activity in rheumatoid arthritis patients

2020 ◽  
Vol 14 (15) ◽  
pp. 1405-1413
Author(s):  
Shuaishuai Chen ◽  
Juping Du ◽  
Weibo Zhao ◽  
Rong Cao ◽  
Na Wang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Disease Activity Score ◽  
High Disease Activity ◽  
Joint Disease ◽  
Activity Score ◽  
Healthy Controls ◽  
Receiver Operating

Aim: Data from 124 rheumatoid arthritis (RA) patients and 69 healthy controls were collected. Materials & methods: ELISA was performed to detect serum FABP4 levels. Results: FABP4 level was elevated in RA patients and positively associated with 28-joint disease activity score, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, total cholesterol, triglyceride and low-density lipoprotein cholesterol. Additionally, the area under the receiver operating characteristic curve for FABP4 was 0.685 for RA patients versus healthy controls (p = 0.001). RA patients were separated into low, moderate and high disease activity based on 28-joint disease activity score. The area under the receiver operating characteristic value was 0.877 for RA patients with high disease activity versus healthy controls (p < 0.001). Conclusion: FABP4 was associated with disease activity in RA patients.

scholarly journals POS0305 PHYSICIAN AND PATIENT ATTITUDES TOWARDS TREAT-TO-TARGET, ITS IMPLEMENTATION AND STATED TREATMENT GOALS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN A REAL-WORLD SETTING ACROSS EUROPE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 378-379
Author(s):  
B. Fautrel ◽  
R. Caporali ◽  
E. Holdsworth ◽  
B. Donaghy ◽  
M. Khalid ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Real World ◽  
Current Treatment ◽  
High Disease Activity ◽  
Clinical State ◽  
Treat To Target ◽  
Treatment Goals ◽  
Research Support ◽  
Reduction Of Pain

Background:The principles of treat to target (T2T) include defining an appropriate treatment target, assessed at pre-defined intervals, with a commitment to changing therapeutic approach if the target is not met (1). T2T is recommended as a key strategy for the treatment of rheumatoid arthritis (RA).Objectives:To explore attitudes towards T2T, its implementation and stated treatment goals among physicians and their patients with RA.Methods:The Adelphi RA Disease Specific Programme™ was a large, quantitative, point-in-time survey conducted amongst rheumatologists (n=296) and their consulting patients with RA (n=3042) in Europe (France, Germany, Italy, Spain, UK) between Q4 2019–Q3 2020. Physicians were recruited via publicly available lists, completing an online survey and medical record extraction for their next 10–12 consecutive patients. The same patients were invited to voluntarily complete a self-report questionnaire (n=1098, 36% response), collecting data on attitudes towards T2T and treatment goals.Results:Physicians reported that 76% of patients were in remission (DAS28: <2.6) or had low disease activity (DAS28: 2.6 – 3.2), and 24% had moderate-high disease activity (DAS28: >3.2). Patient mean age was 53.0 years (SD 14.0), mean time since diagnosis was 7.2 years (SD 7.2). The proportion of patients currently receiving an advanced therapy (AT; defined as biologic or targeted synthetic DMARD) was 68%, of whom 70% were on a first line AT. No difference was observed between disease activity groups.In the physician survey, 86% of physicians stated they followed T2T principals in at least some of their RA patients, and would utilize a T2T approach in RA patients with moderate-high disease activity (61%), the most uncontrolled patients (37%) and those who do not respond well to initial therapy (34%). In this sample of real-world RA patients, 66% were reported by physicians to be on a T2T plan at the time of data collection. The most common physician-reported targets were remission (DAS28: <2.6) (75%), improvement of quality of life (QoL) (41%) and reduction of pain (31%), with 85% of physicians perceiving these treatment goals were fully or partially met. The most stated reasons for not implementing T2T was physician preference not to adjust current treatment (34%), patient preference not to adjust current treatment (23%), and there are no achievable goals for this patient (16%).Overall, 29% of patients reported they were involved in setting their T2T goals, while 34% stated their T2T goals were set by their physicians only, and 29% perceived no T2T goal had been set (n=620). The most common overall T2T goals from the patient perspective were remission (61%), controlling symptoms (41%), and reducing impact on QoL (34%). Of those patients who acknowledged a T2T goal had been set (n=407), 77% reported their T2T goal was fully or partially achieved.Of 719 patients who had moderate-high disease activity, 57% were on a T2T plan, with 46% of physicians perceiving these treatment goals were fully or partially met. The most common physician-stated reason for not implementing T2T was a lack of achievable targets (29%).Conclusion:Rheumatologists in this study reported a strong belief in T2T. The most common physician-set T2T goals were remission, improvement of QoL and reduction of pain, corresponding with T2T goals as reported by patients. However, a third of patients in this cohort were not aware of a defined T2T objective in their management, which may be a result of a perceived lack of achievable goals by physicians. It may be desirable to promote more patient involvement in defining achievable targets amongst those with moderate-high disease activity who despite best efforts may not reach a clinical state of remission. Further research is needed to identify and understand goals important to RA patients.References:[1]van Vollenhoven R. Treat-to-target in rheumatoid arthritis - are we there yet? Nat Rev Rheumatol. 2019;15(3):180-6.Acknowledgements:This study was funded by Galapagos NV, Belgium.Medical writing support was provided by Gary Sidgwick, PhD (Adelphi Real World, Bollington, UK) and editorial support was provided by Debbie Sherwood, BSc, CMPP (Aspire Scientific, Bollington, UK), both funded by Galapagos NV.Disclosure of Interests:Bruno Fautrel Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Celltrion, Fresenius Kabi, Gilead, Janssen, Lilly, Medac, MSD, Mylan, NORDIC Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi-Genzyme, SOBI, UCB, Grant/research support from: AbbVie, Lilly, MSD, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Lilly, Pfizer, Roche, UCB, Sanofi, Fresenius Kabi, Samsung Bioepis, MSD, Consultant of: Galapagos, Gilead, Lilly, Janssen, MSD, Elizabeth Holdsworth Employee of: Adelphi Real World, Bethany Donaghy Employee of: Adelphi Real World, Mona Khalid Shareholder of: Galapagos, Employee of: Galapagos, Mark Moore Shareholder of: Gilead Sciences, Speakers bureau: Gilead Sciences (only as employee), Paid instructor for: Gilead Sciences (only as employee), Consultant of: Gilead Sciences (only as employee), Grant/research support from: Gilead Sciences (only as employee), Employee of: Gilead Sciences, and previously Sanofi and AstraZeneca, Katrien Van Beneden Shareholder of: Galapagos, Employee of: Galapagos, Yves Piette Consultant of: AbbVie, Amgen, Galapagos, Grünenthal and Sandoz, Grant/research support from: Amgen, Mylan and UCB, Susana Romero-Yuste Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Grunenthal, Kern Pharma, Lilly, Roche, Sandoz, Sanofi, UCB, Janssen, Consultant of: AbbVie, Biogen, Fresenius, Galapagos, Gebro, Janssen, Lilly, Grant/research support from: Bristol Myers Squibb, MSD, Novartis, Pfizer, Jasper Broen Shareholder of: Pharming Group, Consultant of: Galapagos, Gilead, Novartis, Peter C. Taylor Consultant of: AbbVie, Biogen, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, Pfizer, Roche, Sanofi, Nordic Pharma, Fresenius, UCB, Grant/research support from: Celgene, Galapagos, Gilead, Lilly

scholarly journals POS0583 ENGINEERED GLOVE TO EVALUATE THE SPEED OF THE HANDS’ MOVEMENTS IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 524.3-525
Author(s):  
M. Patanè ◽  
L. Carmisciano ◽  
E. Hysa ◽  
E. Gotelli ◽  
A. Signori ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Health Assessment ◽  
Continuous Variable ◽  
Test System ◽  
Movement Speed ◽  
Healthy Controls ◽  
Activity Class ◽  
Patient Reported ◽  
Opposition Movements

Background:Rheumatoid arthritis (RA) is a long-term, progressive, and disabling autoimmune disease1. The disease activity can be quantified by the Disease Activity Score 28-joint count – C reactive protein (DAS28crp)2; the evaluation of disability function (DF) is actually mainly performed only by subjective Patient Reported Outcomes (PROs) like Health Assessment Questionnaire (HAQ)3; to investigate the functional aspects of RA hands it is usually used the grip strength (GS)4. However, in the scientific literature no tool, which objectively evaluates movement speed, has been reported. The Hand Test System (HTS, ETT) is an engineered glove (RAGLOVE), nowadays applied for neuroscience studies to evaluate hand motility5Objectives:To objectively evaluate the RA hand’s speed of the fine movements, through the HTS and to compared with a group of age and sex matched healthy controls. To verify the correspondence with the HAQ, DAS28, GS.Methods:55 consecutives RA patients (pts) (6 males, age 61 ± 16 years, mean duration of disease 12 ± 8 years), classified according to 2010 ACR/EULAR criteria6, and 50 matched healthy controls (HCs) were enrolled. After consent, all participants undergone HTS test that recognizes the touches between the finger tips during the opposition movements of the hands in standard sequences of movements, after dressed the glove. A multiple finger evaluation (MFE) and a single finger evaluation (SFE) were performed using a dedicated software that provided the physician the following quantitative parameters: Touch Duration (TD), Inter Tapping Interval (ITI) and Movement Rate (MR). Average time for hand 2 minutes. RA pts compiled the HAQ, performed the GS and a DAS28cpr was performed.The student’s t-test was used to compare the glove’s parameters between the groups whereas the analysis of variance (ANOVA) was utilized to verify potential differences between the populations. In order to evaluate the single correlations, the r and p values of Pearson were employed.Results:For MFE, glove parameters TD and ITI were significantly higher in RA pts than HCs, whereas; MR was significantly lower in RA pts compared to HCs (all p <0.001).For SFE non-affected fingers (not swollen and not tender) of RA pts performed better than a clinically affected fingers, but in any case significantly worse than average HCs fingers (p < 0.001).There is a statistically significant correlation between the GS and MR (r= 0.39 p=0.003) and TD (r=-0.33 p=0.015).TD, ITI e MR of RA pts showed a significant correlation with the total score of the HAQ (r = 0.56, r = 0.39, r = -0.56, all p < 0.001;). DAS28, considered as a continuous variable, proved to be significantly correlated with the TD (r = 0.36, p = 0.009). When the RA patients were grouped according to the disease activity by DAS28cpr7, there was an increase of one third of the TD’s logarithm for each increase in the activity class (linear regression with ordinal predictors, beta = 0.33; 95%CI 0.03, 0.63,p < 0.0297). Finally, even RA pts in remission showed a TD significantly higher compared with HCs (p= 0.034).Conclusion:The RAGLOVE is shown as a new safe and fast tool to evaluate a new objective parameter in the hand’s functionality: the speed of finger movements. In RA pts, an inversely proportional correlation emerges between the speed of movement and disease activity.The significant correlation found with HAQ, highlights the loss of motility of the hands as one of the main determinant of disability. The RAGLOVE is now tested in RA patients undergoing treatment.References:[1]Hakkinen et al Ann Rheum Dis. 2005;[2]Van Der Heijde et al J of Rheum. 1993;[3]Fries et al Arthritis Rheum. 1980;[4]Mathiowetz et al J Hand Surg Am. 1984;[5]Carmisciano et al Eur J Neurol. 2020;[6]Aletaha et al. Ann Rheum Dis. 2010;[7]Aletaha et al Arthritis Rheum 2005.Disclosure of Interests:None declared

scholarly journals POS0563 THE NATURAL COURSE OF RHEUMATOID ARTHRITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE FOCUSING ON LUNG PHYSIOLOGY AND DISEASE ACTIVITY: A PROSPECTIVE COHORT STUDY (PART 2)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 516.1-516
Author(s):  
S. H. Chang ◽  
J. S. Lee ◽  
J. S. Lee ◽  
C. H. Park ◽  
M. U. Kim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Natural Course ◽  
Annual Change ◽  
Low Disease Activity ◽  
Activity Group ◽  
Lung Physiology ◽  
Group A ◽  
Group B ◽  
Group D

Background:Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). However, the effect of RA disease activity on the course of ILD is not yet known.Objectives:To assess the natural course of lung physiology of RA-ILD and the relation between arthritis activity and pulmonary physiology in patients with RA-ILD.Methods:The Korean Rheumatoid Arthritis ILd (KORAIL) cohort is the prospective observational cohort and aims to investigate the natural course of RAILD. Based on either 1987 or 2020 ACR criteria, patients diagnosed with RA and ILD based on CT scan were recruited from six tertiary medical hospitals in Korea since January 2015. RA disease activity was assessed using disease activity (DAS)28-ESR and CRP, annually. Pulmonary function tests (PFT), including FVC and DLCO were conducted annually. According to the transition of DAS28-ESR status, we classified patients into four groups: Group A. persistent remission or low disease activity, Group B. improvement, Group C. worsening, Group D. persistent moderate to high disease activity.Results:We analyzed 143 patients who completed a 2-year follow-up (visit 2) or had died with available PFT results at least twice. Mean duration since RA diagnosis and since ILD diagnosis was 7.6±8.0 and 2.7±3.1 years, respectively. Twenty-four patients were Group A, 33 Group B, 10 Group C and 30 Group D. The mean of FVC (mL) and % of the predicted value in FVC was significantly lower in Group D than in other groups (Table 1). The annual rate of decline in FVC was -42 (95% CI -93~10) mL·year-1 in Group B while -113 (95% CI -206~-21) mL·year-1 in Group C (Figure 1A). The annual decline rate in Group C was further exaggerated in patients with ≥ 80% of FVC predicted (-141, 95% CI -251~-32 mL·year-1). During two years of follow-up, patients ever experienced a relative decline of ≥10% from the enrollment in FVC predicted was 27.3%(n-9/33) in Group B whereas 30.0% (3/10) in Group C. The annual rate of decline in % of DLco predicted value was also the largest in Group C (-4.6 %·year-1, 95%CI -8.5~-0.7), which further exaggerated in patients with ≥ 80% of FVC predicted (-4.9%·year-1, 95 %CI -8.3~-1.5, Figure 1B). Of note, about half of patients with maintained not only low disease activity (Group A) but also moderate to severe disease activity (Group D) improved in DLco at least 10% or more from the enrollment of DLco predicted value (Group A: 54.2%, n=13/24, Group D: 46.7%, n=14/30).Conclusion:RA disease activity is associated with the change of lung physiology in patients with RA-ILD; worsening disease activity associated with a further decrease of annual change in FVC and maintaining low disease activity associated with a further increase of annual change in % of DLco predicted value.Table 1.The analysis of forced vital capacity (FVC) according to disease activity transition group.Group AGroup BGroup CGroup DFVC (mL), mean±SD2810.0±771.12528.8±735.32801.0±952.72048.3±575.7FVC % of predicted, mean±SD87.5±14.586.5±16.693.0±15.677.2±17.3Rate of FVC decline, mL·year-1 (95% CI)-52 (-112,7)-42 (-93,10)-113 (-206, -21)1 (-52, 54)A 10-point decline from V1 in predicted FVC value, n (%)29 (20.3)6 (25.0)6 (18.2)3 (30.0)Relative decline of 10% from the enrollment in predicted FVC value, n (%)35 (24.5)5 (20.8)9 (27.3)3 (30.0)Figure 1.The annual change of pulmonary physiology according to disease activity transition group.Acknowledgements:This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no.HI14C1277).Disclosure of Interests:None declared

Elevated Serum Glucose-6-Phosphate Isomerase Correlates with Histological Disease Activity and Clinical Improvement After Initiation of Therapy in Patients with Rheumatoid Arthritis

2010 ◽  
Vol 37 (12) ◽  
pp. 2452-2461 ◽  
Author(s):  
LIE DAI ◽  
LANG-JING ZHU ◽  
DONG-HUI ZHENG ◽  
YING-QIAN MO ◽  
XIU-NING WEI ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Demographic Data ◽  
Elevated Serum ◽  
Serum Marker ◽  
Serum Glucose ◽  
Healthy Controls ◽  
Synovitis Score ◽  
Initiation Of Therapy ◽  
Activity Indices

Objective.To determine serum glucose-6-phosphate isomerase (GPI) concentrations in patients with rheumatoid arthritis (RA), and to test whether they correlate with objective measures of disease activity.Methods.Sera from 116 patients with RA, 69 patients with non-RA rheumatic diseases, and 101 healthy controls were analyzed. Levels of soluble serum GPI were measured by ELISA. Histological disease activity was determined with the synovitis score in synovial needle biopsies from 58 of the 116 patients with RA. Thirty-one of the 58 synovium samples were stained for CD68, CD3, CD20, CD38, CD79a, and CD34 by immunohistochemistry. Demographic data were collected, as well as serological and clinical variables that indicate RA disease activity, for Spearman correlation analysis.Results.Serum GPI level correlated positively with the synovitis score (r = 0.278, p = 0.034). Significantly higher soluble GPI levels were detected in the RA sera compared with sera from healthy controls and the non-RA disease controls (2.25 ± 2.82 vs 0.03 ± 0.05 and 0.19 ± 0.57 μg/ml, respectively; p < 0.0001). The rate of serum GPI positivity was significantly higher in the RA patients than in the non-RA disease controls (64.7% vs 10.1%; p < 0.0001). Spearman analysis showed no significant correlation between serum GPI level and Disease Activity Score in 28 joints at baseline. After initiation of antirheumatic treatments, GPI levels decreased significantly (2.81 ± 3.12 vs 1.44 ± 2.09 μg/ml; p = 0.016), paralleling improvement of the disease activity indices.Conclusion.Elevated serum GPI may be involved in the synovitis of RA and may prove useful as a serum marker for disease activity of RA.

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