Differential Associations of Inflammatory and Endothelial Biomarkers with Disease Activity in Rheumatoid Arthritis of Short Duration

Abstract

Objectives. To estimate endothelial dysfunction in patients with rheumatoid arthritis (RA) of short duration in relation to disease activity based on the assessment of 28 joints (DAS28). Methods. We studied 29 patients (22 women, mean age 41 (SD, 9) years) with RA of short duration and 29 healthy controls. The RA subjects were divided into those with low (DAS28: 2.6–5.1, n = 18) or high (DAS28 > 5.1, n = 11) disease activity. Exclusion criteria included clinically overt atherosclerosis and other coexistent diseases. Biochemical markers of inflammatory activation and endothelial dysfunction were measured. Results. There were no significant intergroup differences in the majority of classical cardiovascular risk factors. High-sensitivity C-reactive protein, tumor necrosis factor-α, and interleukin-6 were increased in RA subjects. Compared to the controls, levels of soluble vascular cell adhesion molecule-1, von Willebrand factor, and pentraxin-3 were significantly elevated in RA subjects with low disease activity, exhibiting no further significant rises in those with high disease activity. Asymmetric dimethyl-L-arginine, soluble E-selectin, monocyte chemotactic protein-1, and osteoprotegerin were increased only in RA patients with high disease activity. Conclusions. Our findings might suggest a dissociation of pathways governing generalized and joint-specific inflammatory reactions from those involved in endothelial activation and inflammation within the vascular wall.

Serum Adenosine Deaminase as Inflammatory Marker in Rheumatoid Arthritis

“…CRP measurement has been suggested to be beneficial for estimating short term changes in disease progression in RA patients [12,13]. Several studies have reported increased CRP levels in patients with RA [4,14]. In the present study serum levels of both ADA and hsCRP were significantly elevated in RA patients compared to controls.…”

Osteoimmunology: from mice to humans

“…29 IL-6 is increased in RA and even though it is not essential for bone resorption it may contribute to the increased bone resorption in RA. 30 In RA and in other chronic inflammatory conditions, not only bone resorption but also bone formation is affected. The increase in TNF-a during inflammation induces an increase in dickkopf-1 (DKK-1), which is a negative regulator of the Wnt pathway.…”

A New Explanation of Inflammation in Rheumatoid Arthritis Patients With Respect to Claudin-5, Matrix Metalloproteinase-9, and Neuroserpin

“…Recent studies with RA patients have indeed revealed interactions between ED and disease activity; these include soluble human vascular cell adhesion protein 1, von Willebrand factor, pentraxin-3, asymmetric dimethyl-L-arginine, soluble E-selectin, monocyte chemotactic protein-1, and osteoprotegerin. 33 Many of these substances are affected by inflammatory mediators and cytokines, and as specified earlier, contribute to the mechanisms underlying RA pathogenesis. With respect to therapeutic strategies for RA treatment, especially anti-tumor necrosis factor-alpha therapies, most are effective at reducing inflammation, as well as improving endothelial function.…”