Effekte des Chemokins MIP-1α auf Anämie und Entzündungsmechanismen bei Rheumatoider Arthritis

Abstract

Macrophage inflammatory protein-1alpha (MIP-1alpha) is an interesting chemokine because in addition to its variety proinflammatory activities including chemotaxis and immunomodulation, it is a potent inhibitor of hematopoetic stem cell proliferation. Inhibition of erythroid progenitor cells due to MIP-1alpha or other cytokines can play a role in the pathogenesis of anemia which is one of the most common extra-articular features of active rheumatoid arthritis (RA). In 84 patients with RA, serological and immunological parameters were assessed to detect inflammatory mechanisms and anemia in relation to the serum concentrations of MIP-1alpha. All patients fulfilled the ACR criteria for the diagnosis of a definite or classic RA. We used a quantitative enzyme immuno assay for the detection of MIP-1alpha as well as for the measurement of the acute phase protein serum amyloid A (SAA), the erythropoiesis inducer erythropoietin (EPO) and the transferrin receptor (TfR). The immune activation marker neopterin was measured radioimmunologically. Half of the patients with RA were anemic with hemoglobin values below 12 g/dl. MIP-1alpha was found to be elevated significantly in serum of patients with active rheumatoid arthritis and in patients with anemia. Most of the anemic patients with markedly elevated acute phase reactions had an anemia with chronic diseases and not a functional iron deficiency alone. TfR correlated with EPO. The results show that enhanced expression of MIP-1alpha is indicative of systemic inflammation in RA. Moreover, besides the regulation of inflammatory processes, this chemokine may influence the pathogenesis of anemia in RA patients.

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“…On the other hand, increased ESR levels start the generation of endogenous proteins (fibrinogen, α/β globulin) and indicate the disease progression [42]. During the arthritic condition, decreased levels of RBC and Hb, associated with anemic condition due to erythrocyte deformability (shorten the life span of erythrocytes), which result in declined level of RBC during arthritis [43, 44]. It is projected that the declined levels of Hb during arthritis, results in reduction of erythropoietin level (decreased the level of bone marrow erythropoietin level) and premature destruction of RBCs [28, 45].…”

Nimesulide is a Selective COX-2 Inhibitory, Atypical Non-Steroidal Anti-Inflammatory Drug

“…Nimesulide is effective against increased TNF-, PGE 2 and IL-1 levels in endotoxemic rats [44]. The other effects of nimesulide can be summarized as; blockage of superoxide anion releasing from leucocytes, inhibition of phosphodiesterase type IV, prevention of TNF-releasing, increasing glutathione (tGSH) levels in the stomach tissue, blockage of histamine, attenuation of hypochloric acid, and the inhibition of metalloprotease and platelet activating factor (PAF) [45][46][47][48][49][50][51][52].…”

A Comparative Study of Interleukin 6, Inflammatory Markers, Ferritin, and Hematological Profile in Rheumatoid Arthritis Patients with Anemia of Chronic Disease and Iron Deficiency Anemia

“…Anemia is a common characteristic disorder that affects the health of rheumatoid patients [2]. There are many types of anemia in RA such as iron deficiency anemia (IDA), anemia of chronic disease (ACD) or what is known as anemia of inflammation, the combination of both IDA and ACD, and hemolytic anemia [3]. It has been found that ACD is a common type of anemia in RA [4].…”