Role of thrombin anti-thrombin complex (tat)‎ and anti-thrombin III in the pathogenesis of rheumatoid arthritis & osteoarthritis

الملخص EN

Objective: To clarify the role of thrombin Anti-thrombin complex (TAT) and Anti-thrombin III (ATIII) in the pathogenesis of RA and OA.

Besides, to correlate both parameters with disease activity of RA and with the degree of inflammation of the knee in OA patients.

Subjects: The study was performed on 45 subjects, 24 females & 21 males.

They were classified into three groups: Group I included 15 RA patients; they were diagnosed according to the American College of Rheumatology (ACR) revised criteria.

Group II included 15 OA patients; they were diagnosed according to the ACR clinical & radiographic criteria.

Group III included 15 healthy individuals as controls.

They were age & sex matched with the other two groups.

Methodology: All patients & control groups were subjected to full history taking, full clinical examination of the locomotory system and assessment of disease activity in RA patients & assessment of the degree of inflammation of the knee in OA patients.

Synovial fluid from patients & blood samples from all subjects were collected to assess: TAT, AT-III and Hs-CRP in the plasma & synovial fluid, as well as total proteins in synovial fluid.

Radiological evaluation of knees, hands & feet was done for all patients.

Results: There was a significant difference in TAT & AT-III levels in the plasma of all the studied groups, and a highly significant difference in Hs-CRP levels in the plasma of all the studied groups.

There was also a significant difference in TAT level in synovial fluid of both RA & OA groups, and a highly significant difference in AT-III and Hs-CRP of both RA & OA groups.

There was a significant correlation between TAT in synovial fluid, AT-III in plasma and Hs-CRP in both plasma & synovial fluid with most of the parameters of disease activity in RA group.

Also there were significant correlations between TAT in both plasma & synovial fluid with the degree of inflammation of the knee in OA patients.

In RA group, TAT in synovial fluid was highly significantly correlated with AT-III and Hs-CRP in the plasma, and significantly correlated with synovial fluid AT-III and Hs-CRP.

In OA group, TAT in synovial fluid was highly significantly correlated with both TAT in the plasma and AT-III in the synovial fluid, and significantly correlated with AT-III in the plasma.

Conclusion: Thrombin and its inhibitors play an important role in the pathogenesis of both RA & OA.

Also, TAT complex level could be taken as a marker of disease activity.