Serum Level of Endothelial Cell-Specific Molecule -1 (ESM -1) as a New Potential Biomarker for Rheumatoid Arthritis Disease Activity

Background:Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by destruction of the joint cartilage and bone. Endothelial dysfunction (ED) in RA may be related to disease activity. Our objective is to explore serum levels of endothelial cell-specific molecule-1 (ESM-1) as a biomarker for RA disease activity.Methods:A cross-sectional study was carried out and included 83 adult patients with RA, in addition to 20 healthy subjects (age and sex-matched) as a control group. Based on Disease Activity Score in 28 joints (DAS-28), the patient's group was subdivided into four subgroups(remission, mild, moderate and severe disease activity state). The demographic & clinical data, BMI, DAS-28 and Serological assessment [Erythrocyte Sedimentation Rate (ESR), CRP, Rheumatoid Factor (RF) and Anti-Citrullinated Peptide Antibody (ACPA)] were recorded. ESM-1was assayed for all participants.Results:Serum levels of ESM1 were significantly higher in the patient group than the control group (P< 0.0001). ESM-1 serum levels were significantly higher in patients with severe disease activity subgroup compared with patients with remission and mild disease activity subgroups (P< 0.0001). ESM-1 was positively and significantly correlated with DAS-28 score, The Health Assessment Questionnaire Disability Index (HAQ-DI) and modified Larsen score (P= 0.002, 0.0001 & 0.0001 respectively).Conclusion:ESM-1 could be a biomarker for RA disease activity.

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

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666201019115030 ◽

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.

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

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5859 ◽

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

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Influence of Insulin Resistance and TNF-αon the Inflammatory Process, Oxidative Stress, and Disease Activity in Patients with Rheumatoid Arthritis

Oxidative Medicine and Cellular Longevity ◽

10.1155/2016/8962763 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Neide Tomimura Costa ◽

Tatiana Mayumi Veiga Iriyoda ◽

Ana Paula Kallaur ◽

Francieli Delongui ◽

Daniela Frizon Alfieri ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Oxidative Stress ◽

Insulin Resistance ◽

Disease Activity ◽

Inflammatory Process ◽

Cross Sectional Study ◽

Stress Index ◽

Control Group ◽

Cross Sectional ◽

Clinical Trials Registry

The aim of this study was to evaluate the involvement of TNF-αand insulin resistance (IR) in the inflammatory process, oxidative stress, and disease activity in patients with rheumatoid arthritis (RA). This cross-sectional study included 270 subjects (control group,n=97) and RA patients (n=173). RA patients were divided into four groups: the first group without IR and not using antitumor necrosis factor-α(TNF-) (G1, IR− TNF−); the second group without IR and using anti-TNF-α(G2,IR-TNF+); the third group with IR and not using anti-TNF-α(G3, IR+TNF-); and the fourth group with IR and using anti-TNF-α(G4, IR+ TNF+). G3 and G4 had higher (p<0.05) advanced oxidation protein products (AOPPs) and oxidative stress index (OSI) compared to G1. G4 group presented higher (p<0.05) AOPPs and OSI than G2. TRAP was significantly lower in G3 compared to G1. Plasma TNF-αlevels were significantly higher in G4 and G2 compared to G1 (p<0.0001) and G3 (p<0.0001andp<0.01, resp.). The presence of insulin resistance was robustly associated with both oxidative stress and TNF-αlevels. More studies are warranted to verify if IR can be involved in therapeutic failure with TNF-αinhibitors. This trial is registered with Brazilian Clinical Trials Registry Register numberRBR-2jvj92.

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EVALUATION OF D-DIMER SERUM LEVELS AMONG PATIENTS WITH CHRONIC SPONTANEOUS URTICARIA AND ITS CORRELATION WITH DISEASE SEVERITY.

10.36106/gjra/4001428 ◽

2020 ◽

pp. 1-3

Author(s):

Aditi Jaiswal ◽

Kiran Godse

Keyword(s):

Disease Activity ◽

Disease Severity ◽

Rank Correlation ◽

Serum Levels ◽

Analysis Data ◽

Control Group ◽

Tertiary Referral Centre ◽

Cross Sectional ◽

Positive Correlation ◽

D Dimer

Aims: To evaluate D-Dimer serum levels in patients with chronic urticaria and its correlation with disease activity. Settings and Design: Single centre Cross sectional prospective observational age & sex matched case-control study at Dermatology OPD of a tertiary referral centre. Methods and Material: This study was conducted from January 2018 to June 2019. We in-cluded 33 patients with CU and 30 controls . They were recruited from urticaria clinic. All cases were subjected to history taking, general and dermatological examination. The serum levels of D-Dimer were measured by Semiquantitative, immunofiltration kits. Statistical analysis: Data was analysed by Statistical Package for Social Sciences (SPSS) ver-sion 21.0. Tests used were Independent t test/Mann-Whitney Test, Chi-Square test/Fisher’s Exact test, Spearman rank correlation coefficient, Kolmogorov- Smirnov test.. Results: Patients with active CU had elevated D-Dimer serum levels (p<0.0001) when com-pared with the control group (papulo-squamous disorder). Of 33 CSU patients, D-dimer level was elevated in 19 patients (57.58%). There was statistically significant positive correlation between disease severity (UAS7) and plasma D-dimer level (p <.0001, r =0.935). Conclusions: This study showed elevated D-dimer levels in more than half of Indian patients with CSU. There was a positive correlation between plasma D-dimer levels and the severity of disease activity. Investigation for plasma D-dimer level may be an alternative objective way to evaluate disease severity in patients with CSU. Limitations: Low sample size . Semi quantitative method was used instead of ELISA for D-Dimer.

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IL-22 and ACPA Levels and their Relationship to the Disease Activity in Rheumatoid Arthritis Patients

Open Access Journal of Microbiology & Biotechnology ◽

10.23880/oajmb-16000185 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1-7

Author(s):

Khater ES

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Solid Phase ◽

Sandwich Elisa ◽

Control Group ◽

Erosive Disease ◽

Das 28 ◽

Significant Difference ◽

Hs Crp ◽

And Control

Aim: to determine ACPA IgG and IL-22 levels in RA patients and their relationship to the disease activity Place and duration of the study: A cross sectional study and prospective cohort study was performed from August 2020 to January 2021 in rheumatology outpatient clinic and laboratory of Al- Quwayiyah General hospital. Methodology: Forty five rheumatoid arthritis patients were included and 35 healthy participants free of any diseases considered as control group. The patients in this study met the American College of Rheumatology's 2010 guidelines. RA Disease activity was assessed for rheumatoid patients using DAS28 scoring. Serum samples collected from the patients and control to perform ESR, Hs-CRP, RF factors and also IL22 and ACPA IgG which were detected using sandwich ELISA and indirect solid phase enzyme immunoassay techniques respectively. Results: Out of the 45 RA patients, 34(75.6%) were females and 11(24.4%) were males aged from (28-67years) with median patient age 42 years. There was no statistically significant difference regarding age and sex between RA patients and control. Thirty (66.7%) of the 45 RA patients had low disease activity or remission, while 15 (33.3%) had moderate to extreme disease activity. Thirty two 32(71.1%) patients of the 45 RA patients had erosive disease. The level of ESR, hs-CRP and RF are increased in the patient group than control, in spite that there were significant differences in the Mean± SD among RA group and control group regarding RF, there was no significant statistical differences ESR, hs-CRP. in the study there was an increase in ACPA and IL-22 levels in patients suffering of RA; 21.52±1.29 U/ml and 71.22±10.63 pg\ml. respectively. While among control there was low serum levels; 14.06±2.01U/ml 33.25±2.41pg\ml and respectively. Significant statistical difference was observed regarding IL-22 and ACPA IgG levels among RA patients and control (P=0.038 and P=0.019 respectively). There is a significant positive relationship (positive correlation) detected between ACPA and IL-22 levels, (r=-0.810; p=0.597). The levels of IL-22 and ACPA were significantly associated with DAS 28. Their relationship was strong as the r value was 0.427 and 0.411 respectively. Conclusion: IL-22 and ACPA IgG levels were highly increased among RA patients in comparison to the control group. The IL-22 and ACPA IgG levels were strongly correlated with the rheumatoid disease activity, DAS 28. These results suggest that Il-22 can be used in association with ACPA IgG level as diagnostic and prognostic markers of rheumatoid arthritis

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Can Rheumatoid factor and Anti-cyclic citrullinated peptides predict true remission in rheumatoid arthritis patients? Study of relationship between autoantibodies levels and muskuloskelatal ultrasound findings in a sample cohort of Egyptian patients in clinical remission

10.21203/rs.3.rs-324261/v1 ◽

2021 ◽

Author(s):

Eman Hassan Al Sayed ◽

Doaa Shaker Amin

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Rheumatoid Factor ◽

Clinical Remission ◽

Power Doppler ◽

Serum Levels ◽

Cross Sectional Study ◽

University Hospital ◽

Gray Scale ◽

Cross Sectional

Abstract BackgroundTrue remission is the ultimate goal for rheumatoid arthritis (RA) therapy. Our aim was to investigate the relationship between serum levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptides (Anti-CCP) and ultrasonographic (US) findings in Egyptian RA patients in clinical remission.MethodsUsing data from a cross-sectional study on 50 RA patients in clinical remission or low disease activity (LDA) as defined by disease activity score (DAS28-ESR) cutoff points, performed in Alexandria University Hospital; we analyzed statistical relationships and correlations between RF, Anti-CCP) and Gray Scale (GS) and Power Doppler (PD) US using US7 score. US remission was defined as on a GS ≤ 1 and PD = 0. ResultsAmong 34 patients in clinical remission, 61.8% (21) of patients in clinical remission were in ultrasonographic remission, and 38.2% (13) of patients in clinical remission had subclinical ultrasonographic activity. Patients in clinical remission with US remission had significantly higher Anti-CCP (p= 0.006) but not RF (p= 0.086), than those in clinical remission with US subclinical activity. Anti-CCP positively correlated with synovitis score by power Doppler US (PDUS) (rs= 0.553, p= 0.001), and tenosynovitis/paratenonitis score by gray scale US(GSUS) (rs=0.389, p= 0.023).ConclusionWe demonstrated that patients in clinical RA remission with subclinical US activity had higher serum levels of Anti-CCP, but not RF. Such an association should guide further treatment decisions for those patients.

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Serum chemerin levels: A potential biomarker of joint inflammation in women with rheumatoid arthritis

PLoS ONE ◽

10.1371/journal.pone.0255854 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0255854

Author(s):

Fabiola Gonzalez-Ponce ◽

Jorge I. Gamez-Nava ◽

Emilio E. Perez-Guerrero ◽

Ana M. Saldaña-Cruz ◽

Maria L. Vazquez-Villegas ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Logistic Regression ◽

Regression Analysis ◽

Disease Activity ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

Logistic Regression Analysis ◽

Fat Mass ◽

Severe Disease ◽

Potential Biomarker

Background Chemerin has a potential role in perpetuating inflammation in autoimmune diseases. Nevertheless, to date, there is no conclusive information on whether high chemerin levels increase the severity of rheumatoid arthritis (RA). Therefore, this study evaluated whether serum chemerin is a biomarker of disease activity in RA patients. Methods Study design: cross-sectional. The assessment included clinical and laboratory characteristics, body mass index (BMI) and fat mass. The severity of the disease activity was identified according to the DAS28-CRP index as follows: A) RA with a DAS28-CRP≤2.9 (remission/mild activity) and B) RA with a DAS28-CRP>2.9 (moderate/severe activity). Serum chemerin concentrations were measured by ELISA, and ≥103 ng/mL was considered a high level. Logistic regression analysis was applied to determine whether high chemerin levels were associated with disease activity in RA after adjusting for confounders. Multiple regression analysis was performed to identify variables associated with chemerin levels. Results Of 210 RA patients, 89 (42%) subjects had moderate/severe disease activity and had higher serum chemerin levels than patients with low disease activity or remission (86 ± 34 vs 73± 27; p = 0.003). Serum chemerin correlated with the number of swollen joints (r = 0.15; p = 0.03), DAS28-CRP (r = 0.22; p = 0.002), and C-reactive protein levels (r = 0.14; p = 0.04), but no correlation was observed with BMI and fat mass. In the adjusted logistic regression analysis, high chemerin levels (≥103 ng/mL) were associated with an increased risk of moderate/severe disease activity (OR: 2.76, 95% CI 1.35–5.62; p = 0.005). In the multiple regression analysis, after adjusting for potential confounders, serum chemerin levels were associated with higher DAS28-CRP (p = 0.002). Conclusions Higher chemerin levels increased the risk of moderate and severe disease activity in RA. These results support the role of chemerin as a marker of inflammation in RA. Follow-up studies will identify if maintaining low chemerin levels can be used as a therapeutic target.

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Prognostic Significance of IL-17,And IL-13 Along With IL-23R Gene Polymorphisms in Patients with Rheumatoid Arthritis in Iraqi Patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9ispl1.1358 ◽

2018 ◽

Vol 9 (SPL1) ◽

Author(s):

Ibrahim A Altamemi ◽

Sally Alkhafaji

Keyword(s):

Rheumatoid Arthritis ◽

Gene Polymorphism ◽

Disease Activity ◽

Prognostic Value ◽

Systemic Disease ◽

Expression Level ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Das 28 ◽

Control Serum

Rheumatoid arthritis is a systemic disease with very complex pathogenesis and feature of chronic synovitis. The biological effect of polymorphism on expression and functionality of IL-23R such as SNP can have functional and phenotypic consequences that make Il-23R as a risk factor for RA disease. Moreover recently there is a new trends to find out a new noninvasive prognostic biomarker for RA disease which may help in fallowing up disease. Thus the aim of present work is to find out if there prognostic value for IL-13 and IL-17in Rheumatoid arthritis through linking its expression level with disease activity score (DAS). Also To study if there is a role for IL-23R 11209026 gene polymorphism in disease susceptibility in Iraqi community by using healthy volunteer as a control group. To achieve this goal a Case control study has been conducted on 40 patient and 40 matched apparently health control. serum IL-17 and IL-13 concentration were measure by enzyme Linked immunosorbent assay According to manufactural instruction,measurement of disease activity was determine according to DAS 28 Score.RFLP PCR was used to study SNP of IL-23R gene polymorphism for patient and control group. Data were summarized, presented and analyzed using statistical package for social science (SPSS version 23). Result of present study found there was significant association between serum IL-17 and IL-13 level and RA disease (P<0, 001; and P<0, 001respectively). Moreover,there is significant positive correlation between expression level of both IL-17 and IL-13 with DAS28 (0.044,and 0.034 respectively). According to Receptor operating Curve both of IL-17 and IL-13 found to have high specificity and sensitivity 100%. Regarding to IL-23 R gene polymorphism,there was no significant correlation between rs11209026 gene polymorphism and susceptibility to rheumatoid arthritis patients in Iraqi community. Thus,present study showed that the concentrations of IL-13 and IL-17 significantly correlated with disease severity and DAS 28 which reflect their prognostic value in RA. Moreover,present study demonstrated that there was no significant association between Il-23R gene rs11209026 polymorphism and susceptibility to RA in Iraqi population.

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Evaluating the Relationship Between Serum Level of Interleukin-6 and Rheumatoid Arthritis Severity and Disease Activity

Current Rheumatology Reviews ◽

10.2174/1573397115666190206144223 ◽

2020 ◽

Vol 16 (3) ◽

pp. 249-255 ◽

Cited By ~ 4

Author(s):

Elham Rajaei ◽

Karim Mowla ◽

Qodratollah Hayati ◽

Ali Ghorbani ◽

Mehrdad Dargahi-Malamir ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Serum Level ◽

Interleukin 6 ◽

Significant Relationship ◽

Serum Levels ◽

P Value ◽

Das28 Score ◽

Cross Sectional ◽

Das 28 ◽

The Relationship

Aim: The aim of this study was to evaluate the relationship between Interleukin-6 (IL-6) serum level and the severity and activity of Rheumatoid Arthritis (RA). Methods: In this cross-sectional study, 120 RA patients referred to the rheumatology clinic, the patients were diagnosed by rheumatologists according to ACR / EULAR 2010 criteria. Based on DAS28 score the patients were divided into 4 groups: Remission, Mild, Moderate and Severe. Each group contained 30 patients. Serum levels of Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), anti-Cyclic Citrullinated Peptide (anti-CCP) and Rheumatoid Factor (RF) and serum levels of IL-6, were measured. The relationship between these factors was measured and compared to the relationship between IL-6 and these factors, and the activity of the disease was evaluated based on DAS-28. Results: This study showed that the serum level of IL-6 has a significant relationship with RA activity according to DAS-28 (P value <0.001). There is also a significant relationship between the ESR level, the number of painful joints, and the number of swollen joints, and the severity of the disease based on VAS. Conclusion: Generally the findings of this study indicate that serum level of IL-6 plays an important role in the severity and activity of RA disease and can be considered as a determining factor in evaluating the severity of RA in RA patients and it is a good guide for a step up or down of treatment.

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Study of Serum and Synovial Fluid Levels of Calprotectin of Rheumatoid Arthritis Patients in Correlation with Disease Activity and Severity

10.51429/ejmm29306 ◽

2020 ◽

Vol 29 (3) ◽

pp. 47-51

Author(s):

Dalia A. Elsayed ◽

Samy E. Egila ◽

Yaser A. Abd El-Hammed ◽

Rasha A. Elsayed ◽

Noha Hosni Ibrahim

Keyword(s):

Rheumatoid Arthritis ◽

Synovial Fluid ◽

Disease Activity ◽

Adult Population ◽

Serum Levels ◽

Developed Countries ◽

University Hospital ◽

Control Group ◽

Prognostic Accuracy ◽

Fluid Levels

inflammatory autoimmune disease with a frequency of 0.5–1.0% between the adult population of developed countries. It is marked by chronic inflammation of synovial tissue and accompianed by damage of the articular cartilage and adjecent bone, leading to substantial disability. Objectives: The aim of this study is to determine serum and synovial fluid levels of calprotectin in rheumatoid arthritis patients and to determine its relation with disease activity and severity. Methodology: This study was carried out on 40 rheumatoid arthritis patients who were admitted to Rheumatology, Rehabilitation and Physical Medicine Outpatient’ clinic and Inpatient Department of Benha University Hospital .Also Thirty age and sex matched( 28 females and 2 males ) apparently healthy volunteers were included in the study as a control group . All patients were assessed by full medical history, clinical examination, functional assessment, laboratory investigations including CBC, ESR ,CRP, liver functions, RF, Anticcp antibody, and Xrays were done to both hands. Serum and synovial levels of calprotectien were measured using the ELISA technique. Results: Serum levels of calprotectien were significantly higher in RA patients than healthy subjects [p<0.001], also there was a highly statistically significant increase in the mean synovial fluid calprotectin levels than mean serum calprotectien levels [p<0.001]. Local and systemic levels of calprotectin correlate with clinical, immunological and instrumental assessments of disease activity and the inflammatory degree of the joint. Conclusion: Calprotectin could be used as a new biomarker for monitoring the disease activity and severity of RA. Larger sets are needed to confirm the diagnostic and prognostic accuracy of calprotectin in RA

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