Serum levels of hyaluronic acid [HA] and cartilage oligomeric matrix protein [COMP] as predictors of disease progression in rheumatoid arthritis

To measure the serum concentrations of specific cartilage and bone molecules reflecting tissue turnover to investigate disease activity. The study included 30 rheumatoid arthritis [RA] patients with age range 42 - 66 years. Sixteen patients had rapid erosive disease and fourteen had slow erosive, compared with 20 matched apparently healthy volunteers. All studied individuals were subjected to full history taking, clinical examination and laboratory investigations including measurement of serum levels of cartilage oligomeric matrix protein [COMP], hyaluronic acid [HA], high sensitive C- reactive protein [CRP], erythrocyte sedimentation rate [ESR] and RF concentration as well as measurement of activity of RA by disease activity score [DAS] 28 joint counts. The study showed a significantly higher values of COMP, HA, CRP and ESR in slow erosive [p<0.001] and rapid erosive [p<0.0001] RA patients when compared to controls. There were significantly higher values of COMP, HA, CRP and ESR in rapid erosive RA patients compared to slow erosive RA patients. A significant positive correlation between serum levels of COMP and HA and age, disease duration, Larsen score, DAS and CRP and ESR was found. Also there was a significant positive correlation between serum levels of COMP and HA [r = 0.674, p<0.01]. It could be concluded that the measurement of some serological biomarkers that reflect bone and cartilage destruction in RA patients, could be used to investigate disease activity and increase the knowledge of the basic pathophysiology of joint disease

Serum and synovial oncostatin M and leukemia inhibitory factor in rheumatoid and osteoarthritis

To measure levels of oncostatin M [OSM] and leukemia inhibitory factors [LIF] in the serum and synovial fluid of rheumatoid arthritis [RA] and osteoarthritis [OA] patients. Also, to correlate their levels with the parameters of disease activity in RA and severity in both RA and OA. This study was conducted on 20 RA patients, 10 OA patients and 10 healthy controls. Serum and synovial fluid levels of both OSM and LIF were measured using quantitative sandwich enzyme immunoassay technique. The mean levels of serum and synovial OSM as well as LIF were significantly higher in RA patients than controls [30.3 +/- 14.5, 252 +/- 117, 23.5 +/- 5.2, 41.8 +/- 7.2 pg/ml respectively, p<0.001]. Similar findings were also detected only in synovial OSM and LIF of OA patients [39.5 +/- 4.8, 22.4 +/- 4.5 pg/ml respectively, p <0.001]. On comparing RA and OA patients, there was a highly significant increase in the serum and synovial OSM as well as LIF in RA patients [p <0.001]. Also, there was a highly significant correlation between the serum and synovial OSM in RA and OA patients. Similar findings were found between synovial OSM and LIF as regards the activity score, total number of WBCs and ESR. Stepwise multiregression analysis revealed that serum LIF and ESR were the best parameters to discriminate patients with more active RA. On the other hand, serum OSM, peripheral WBC count and synovial LIF were the best parameters to detect the severity of the disease. Our results confirm the role of both OSM and LIF as important factors that mediate the pathophysiologic events in RA, besides their role in detection of activity of RA and severity of both RA and OA