Value of serum and synovial fluid activin a and inhibin a in some rheumatic diseases

الملخص EN

Background : active is a growth and differentiation factor of many cell types and has recently been implicated in inflammatory processes.

Clinical data demonstrating roles of active and its antagonist inhibit in inflammatory arthropathies, are lacking.

The Aim of the Study is to measure serum and synovial fluid levels of active A and inhibit A in patients with rheumatoid arthritis (RA) systemic lupus erythematous (SLE) and osteoarthritis (OA) and correlate them with disease activity parameters.

Subjects and Methods : this study included 60 patients with three rheumatic diseases (20 with RA, 20 with SLE and 20 with OA), as well as ten healthy subjects as a control group.

All of them were subjected to complete history, physical and musculoskeletal examination and estimation of disease activity index (DAS-28) for RA and (SLEDAI) for SLE.

The following investigations were done for all subjects; serum and synovial active A and inhibit A; in addition to complete blood picture, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), antinuclear antibodies (ANA),anti-dsDNA, serum complement( C3, 4 )and X rays on affected joints Results : the mean values of serum active A were significantly higher in RA, SLE and OA than controls (P < 0.001) also in RA and SLE versus OA (P < 0.05 for both).

The mean values of serum inhibit A were significantly higher in all studied groups than controls (P < 0.05 for RA and OA and P < 0.001 for SLE).

Also serum inhibit levels were significantly higher in SLE versus OA P < 0.001, but there was no significant differences between RA and SLE.

Synovial fluid active and inhibit A were significantly higher in RA than OA (P < 0.05 for both).

Positive correlations were found between serum active A and disease activity parameters of RA morning stiffness (MS), Ritchie index (RI), ESR, CRP and DAS 28) P < 0.05, for all.

Also positive correlation was found between serum inhibit A and RI in RA patient (P < 0.05).

In SLE, positive correlations were found between serum active A and inhibit A with ESR (P<0.001 for active and P < 0.05 for inhibit A and SLEDAI (P < 0.001 for both active and inhibit).

No correlation were found between synovial active and disease activity and negative correlation between synovial inhibit and ESR Conclusions : the significant increase of serum and synovial active A and inhibit A in RA and SLE and their positive correlations with disease activity parameters of RA and SLE suggest pro- inflammatory action .However the lack of correlations or negative correlation of their synovial levels with disease activity may indicate their anti-inflammatory action.

We recommended further studies to detect the exact role of active A and inhibit A.