Study of some biological markers in the assessment of rheumatoid arthritis activity

الملخص EN

The aim of this study : was to detect the correlation of biological markers in RA and their correlation to disease activity.

Materials : Fifty RA patients were diagnosed according to the American College of Rheumatology (ACR) criteria.

They were divided into two subgroups: those with active disease (No.

= 30) and those in the chronic stage (No.

= 20) according to Scott’s criteria.

They were 8 males and 42 females, their mean age was 45.9 ± 7.8 SD, and their age ranged from 33.9 to 65.2 yr.

The disease duration of RA was 7.7 ± 4.3 yr (ranged from 11 months to 22 years).

Methodology : all patients were subjected to complete physical examination including: (1) duration of morning stiffness (expressed in minutes); (2) number of painful / tender joints on pressure or passive motion (of the total 53 diarthrodial joints) ; (3) the number of swollen joints (of a total 44 diarthrodial joints) ; (4) Ritchie articular index (RAI) and (5) laboratory investigations that included (a) Erythrocyte sedimentation rate (ESR) mm / 1oh (b) C- Reactive protein (CRP), (c) Complete blood count (CBC), (d) Latex agglutination test for estimating rheumatoid factor (RF) and (e) Assessment of TNF-alpha, IL-1 α and ICAM-1 using ELISA.

Results: The two subgroups were similar for sex ratio, age (47.4 ± 8.5 yr 43.7 ± 6.1 yr) and disease duration (7.9 ± 3.7 yr 7.3 ± 5.2 yr) with no significant statistical difference.

There was a significant difference (p < 0.001) of indices of disease activity (morning stiffness, number of tender / swollen joints, RAI, ESR and CRP) in active RA patients (group A) as compared to chronic RA patient (group B).

Also, a statistical significant increase was found in serum concentration of cytokines (TNF-a, IL-1 a and ICAM-1) in the Active RA group as compared to chronic RA patients p<0.001.

The correlation study determined a significant correlation between the measured cytokine serum concentrations with indices of disease activity (morning stiffness, swollen / tender joints, RAI, ESR, CRP) in the active group A (R > 0.25, p < 0.05).

On the other hand, there was no significant correlation with age and disease duration in both groups with cytokine levels (r < 025, p > 0.05).

There was no significant correlation between cytokine levels and indices of disease activity in group B (r < 0.25, p > 0.05); except a weak significant correlation between IL-1 a and ESR and CRP.

Conclusion : these findings suggested that measuring serum TNF-a, IL-1 a and ICAM-1 may be useful for monitoring disease activity and in the follow up the effect of therapy.