AbstractRheumatoid arthritis (RA) is a chronic inflammatory
disease characterized by synovial inflammation
and destruction of joint cartilage and bone. Different
cytokines play important role in the processes that cause
articular destruction and extra-articular manifestations
in RA. The contribution of cytokines representing the Th1
(INF-γ), Th2 (IL-4) and IL-17A to the pathogenesis of early
RA and bone mineral density (BMD) loss in still poorly
understood. Serum samples of 38 early RA patients were
evaluated for erythrocyte sedimentation rate (ESR), rheumatoid
factor (RF), C-reactive protein (CRP), anti-cyclic
citrullinated peptide antibodies (anti-CCP) and for the
tested cytokines (IL-17A, IL-4 and INF-γ). BMD was evaluated
by dualenergyX-ray absorptiometry (DXA). Disease
activity score (DAS28) calculation was assessed for all
patients. Control serum samples were obtained from 34
healthy volunteers. The levels of tested cytokines were
significantly higher (IL-17A, p<0.001; INF-γ, P<0.001; IL-4,
P<0.01) in patients with early RA, compared to the healthy
controls. In early RA patients, strong correlation of serum
IL-17A was found with DAS28, ESR and CRP. Also, a significant
negative correlation was found between serum
INF-γ levels and the DAS28 score. Significantly positive
correlation of BMD values and CRP, DAS28 IL-17A were also demonstrated. DXA analysis revealed that the most
common site for osteoporosis was the lumbar spine followed
by the femoral neck. BMD values significantly correlated
with CRP, DAS28 score and IL-17A serum levels.
The mean serum IL-17A levels, in patients with early RA,
corresponded with disease activity, severity and BMD
loss, indicating the potential usefulness of serum IL-17A
in defining the disease activity and bone remodeling.
Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NF B ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis
