Relation between serum visfatin and clinical severity in different stages of rheumatoid arthritis

الملخص EN

Objective Visfatin is one of the recently discovered adipokines that plays important proinflammatory and catabolic roles in rheumatoid arthritis (RA).

Proinflammatory cytokines, such as interleukin (IL)-1, IL-6, IL-15, IL-18, and tumor necrosis factor-a (TNF-a), induce a number of physiological changes that result in the characteristic signs of inflammation.

As inflammation is the major factor leading to structural damage, it is critical to achieve rapid suppression of inflammation to maximize disease control.

Therefore, early diagnosis and treatment of RA is of paramount importance.

As information on the relation between visfatin and disease activity in RA patients is conflicting and little is known about its role in joint damage, the present study was designed to evaluate the role of serum visfatin as a recent proinflammatory marker in RA according to the activity scores of disease to assess the possibility of introducing serum visfatin in the diagnosis and monitoring of RA patients and to determine the correlation between its serum level and other cytokines (IL-6 and TNF-a) and other laboratory biomarkers.

Patients and methods This study was carried out on a total of 80 individuals; 60 of these were (48 women, 80%, 12 men, 20%) diagnosed with RA according to the American College of Rheumatology/The European League Against Rheumatism 2010 criteria and 20 healthy individuals were included as controls (10 women, 50%, 10 men, 50%).

RA patients were classified into three groups: group I (severe RA) included 20 RA patients, group II (moderate RA) included 20 RA patients, and group III (mild RA) included 20 RA patients according to clinical evaluation for disease activity assessed using a 28 joint disease activity score (DAS-28).

Blood samples were obtained from patients and controls for complete blood count and erythrocyte sedimentation rate.

The sera of patients were collected for enzyme-linked immunosorbent assay estimation of serum visfatin, IL-6, and TNF-a.

C-reactive protein (CRP) and rheumatoid factor (RF) were determined using the turbidimetry quantitative method.

Results Comparison of the RA and control groups showed that the mean serum levels of visfatin, platelets (PLT), ESR, IL-6, CRP, and RF were significantly higher in RA patients than in the control group.

Comparison of the mild, moderate, and severe RA groups showed that the mean levels of visfatin and IL-6 were significantly higher in the severe RA group than the moderate RA group, which was significantly higher than that of the mild RA group.

There was a significant positive correlation between serum visfatin and IL-6, ESR, CRP, TNF-a, and DAS-28 in the RA group.

Conclusion Visfatin plays a role in the pathogenesis of RA and could be considered as a disease marker in RA and a marker of joint damage and hence as a potential therapeutic target for RA.

The findings of the present study also indicate that serum visfatin and IL-6 might be of diagnostic value for RA; however, the combined diagnosis using serum visfatin, IL-6, and the RF test can improve the diagnosis of RA in the early stage.

Further studies are required to determine the possibility of introducing visfatin as a potential therapeutic target especially in early RA to prevent erosions.