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

Activin is a growth and differentiation factor of many cell types and has recently been implanted in inflammatory processes. Clinical data demonstrating roles of activin and its antagonist inhibin in inflammatory arthropathies, are lacking. The Study is to measure serum and synovial fluid levels of activin A and inhibin A in patients with rheumatoid arthritis [RA] systemic lupus erythematosus [SLE] and osteoarthritis [OA] and correlate them with disease activity parameters. 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 activin A and inhibin 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 [C 3, 4] and Xrays on affected joints. The mean values of serum activin 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 inhibin 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 inhibin levels were significantly higher in SLE versus OA P<0.001, but there was no significant differences between RA and SLE. Synovial fluid activin and inhibin A were significantly higher in RA than OA [P<0.05 for both]. Positive correlations were found between serum activin 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 inhibin A and RI in RA patient [P<0.05]. In SLE, positive correlations were found between serum activin A and inhibin A with ESR [P<0.001 for activin and P<0.05 for inhibin A and SLEDAI [P<0.001 for both activin and inhibin]. No correlation were found between synovial activin and disease activity and negative correlation between synovial inhibin and ESR. The significant increase of serum and synovial activin A and inhibin 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 activin A and inhibin A

Thyroid disorders in systemic lupus erythematosus and rheumatoid arthritis

Aim: Thyroid disorders are not uncommon in systemic lupus erythematosus [SLE] and rheumatoid arthritis [RA]. However, the association between SLE and RA with autoimmune thyroid diseases is conflicting. This study was designed to determine the patterns of thyroid dysfunction in SLE and RA in Assiut University Hospital. Subjects and Twenty patients with SLE and another twenty with RA were studied in addition to 20 healthy age- and sex-matched controls. All patients were subjected to complete history taking, thorough clinical examination and joint examination. All patients and controls were subjected to the following investigations: serum T3, T4, TSH, antithyroglobulin antibodies [ATGAb] and thyroid peroxidase antibodies [TPOAb]. Also, complete blood picture, ESR, RF, ANA, CRP and LE cells were determined. Fifty percent of SLE patients showed thyroid dysfunction compared to 15% of RA [P<0.05]. In SLE group, 20% had euthyroid sick syndrome, 20% had hypothyroidisrn [10% subclinical and 10% overt], and 10% had hyperthyroidism [5% subclinical and 5% overt]. However in RA, 10% had hypothyroidisrn [subclinical] and 5% had subclinical hyperthyroidism. TPOAb was found in 15% of SLE and 5% of RA patients and 10% of controls, but the titre was higher in SLE and RA patients. Also ATGAb was found in 5% of SLE and 30% of RA patients and 10% of controls, but the titre was higher in SLE and RA patients. Conclusions: Thyroid dysfunction was common in SLE [in particular] and RA. Euthyroid sick syndrome and hypothyroidism were the most common thyroid disorders in SLE. In RA hypothyroidism was more common than hyperthyroidism. SLE and RA were associated with antithyroid antibodies [TPOAb in SLE and ATGAb in RA]. We recommend the performance of thyroid function tests in patients with SLE [in particular] and RA as a part of biochemical and immunological profile

Up-date insight into joint damage in rheumatoid arthritis study of serum and synovial fluid markers: soluble interleukin-2 receptor, hyaluronan, and alpha acid glycoprotein

This study aimed to measure serum and synovial fluid [SE] levels of soluble interleukin-2 receptor [sIL-2R], hyaluronic [hyaluronic acid, HA] and alpha-1 acid glycoprotein [AGP] in patients with rheumatoid arthritis and determined whether they correlated with clinical and laboratory parameters of disease activity and evaluate their values as specific markers for inflammation and joint damage. The sIL-2R levels were determined by ELISA, whereas serum and synovial fluid levels of both hyaluronan and AGP were determined by colorimetric methods. Twenty-five serum and eleven SF samples were obtained from patients with RA and twenty serum samples from age and sex matched controls. The results indicated that serum and synovial fluid of sIL-2R and HA might be more relevant markers of synovitis and inflammation. Their measurements in RA patients is useful in assessing disease activity, while serum and synovial fluid levels of AGP is considered as a useful marker in early rheumatoid arthritis