Assessment of synovitis in early rheumatoid arthritis by CXCL13 serum levels and power doppler ultrasonography: correlation with disease activity

Assessment of synovitis in rheumatoid arthritis [RA] is a major issue for proper treatment; it has been proven that high resolution ultrasound [US] examination could be of valuable help. The B-cell chemokine, CXCL13, is a proposed serum biomarker of synovitis in RA. We aimed to find out the presence of synovitis in patients with recent-onset RA and its correlation with disease activity. We evaluated 30 patients with early RA for the presence and degree of synovitis by performing high resolution US and obtaining serum CXCL13 levels. In addition, we correlated these results with disease activity score 28 [DAS 28]. Results of high resolution US and serum CXCL13 were also obtained for 20 healthy age- and sex-matched volunteers and served as controls. Serum CXCL13 level was significantly increased in early RA patients vs. controls [p < 0.001]. High resolution US revealed that RA patients had a significant increased synovial thickness and high power Doppler US score. In RA patients, DAS 28 had a significant correlation with serum CXCL13 [r = 0.42, p = 0.02], synovial thickness [r = 0.39, p = 0.03] and power Doppler US score [r = 0.43, p = 0.02]. Serum CXCL13 level correlated with synovial thickness [r = 0.63, p = 0.001] and power Doppler US score [r = 0.69, p = 0.001] Recent-onset RA patients suffer from synovitis as evidenced by significantly increased serum CXCL13 and by high resolution US. Serum CXCL13 is a reliable marker of synovial inflammation which correlates better with synovial thickening and power Doppler US scores than DAS28

study of serum levels of B cell-attracting chemokine-13 [CXCL 13] and rheumatologic manifestations of chronic hepatitis C virus infection in a cohort of Egyptian patients

Many rheumatologic manifestations have been associated with Hepatitis C virus [HCV] infection including; arthralgia, myalgia, fatigue, fibromyalgia, vasculitis, and sicca syndrome. The relationship between emergence and persistence of intrahepatic or circulating B cell clonotypes and HCV infection is still unknown. However accumulating evidences indicate that certain chemokines play a critical role in providing the appropriate environment for activation and expansion of naive lymphocytes, one of these chemokines is B cell-attracting chemokine-13 [CXCL13]. CXCL13 is a major regulator of B-cell trafficking. This study evaluates circulating levels of CXCL13 protein in chronically HCV-infected Egyptian patients compared with healthy controls and its association with articular synovial hypertrophy. Rheumatic manifestations were present in 85% of patients; included fatigue [20%], arthralgia [the commonest manifestation] [65%], fibromyalgia [22%], myalgia [37%], Rayunad's phenomenon [10%], peripheral neuropathy and arthritis [2.5%], and tendenitis [7.5]. Cryoglobulins recorded in this study were of type II and III mixed cryoglobulins [MC] positive in 25% all of which showed positive rheumatoid factor [RF]. Significant low levels of C3 and C4 were reported in the patient group. CXCL13 serum levels were significantly high in the patient group especially in the MC positive group compared to controls. The highest levels of CXCL13 were significantly associated with rheumatologic manifestations with or without mixed cryoglobulinemia and significantly associated with articular synovial hypertrophy