Circulating soluble tumour necrosis factor receptors in rheumatoid arthritis

Two types of tumur necrosis factor receptors, TNF-RI and TNF-RII, have been identified. It has been suggested that levels of soluble TNF receptors in the serum can serve as markers of disease activity in rheumatoid arthritis [RA]. This work was designed to measure the soluble TNF-RI and RII in serum of RA patients during disease activity and to find out if their levels reflect clinical response in these patients after methotrexate therapy for 24 weeks. This study was conducted on 30 patients with active RA and 16 healthy controls. The soluble TNF receptors were assayed before and after methotrexate therapy using ELISA technique. Our study revealed that the concentrations of soluble TNF-RI [P55] and RII [P75] were significantly higher in RA patients during disease activity compared to healthy controls [P<0.001 for each receptor]. After methotrexate therapy, a significant decrease in P55 sTNF-R concentration was associated with clinical improvement [P<0.001] while the decrease in P75 sTNFR concentration was found to be insignificant. We conclude that sTNF receptors [P55 and P75] serve as markers of disease activity in RA and we can consider P55 sTNF- R as a marker of clinical response and drug efficacy

Role of heat shock proteins in the pathogenesis of arthritis associated with ulcerative colitis

Arthritis is a well recognised association of inflammatory bowel diseases. The cause of this arthritis is not yet clear but it is likely to be an immunological reaction to one of many bacterial antigens to which the bowel are exposed. One of such group, the heat shock proteins [HSPs], was investigated. These are immunodominant antigens of a wide variety of infectious microorganisms and have varying amino acid chain sequences some of which are similar to those found in human tissues. Antibodies to human HSP 60 and HSP 90 were measured in the serum of patients with ulcerative colitis, with and without arthritis, and in normal age and sex matched healthy controls. The severity of ulcerative colitis was assessed during exacerbation by numbers of motions per day, weight loss, pulse, temperature, ESR and serum albumin. The nature of the organisms colonising the large intestine was determined by bacteriological examination of stool. Higher mean titres of serum IgG anti-human HSP 60 and HSP 90 antibodies were found in all patients with ulcerative colitis than in healthy controls. Both types of antibodies were higher in patients in whom the intestine were colonised with E. coli. In these ulcerative colitis patients, serum IgG anti-human HSP 60 and HSP 90 antibodies were found to be higher in arthritic patients than in non arthritic and the elevation in anti-human HSP 60 antibodies was found to be significant. These findings suggest that arthritis associated with ulcerative colitis despite, being seronegative for rheumatoid factor, was associated with more sever ulcerative colitis and with a greater inflammatory response to heat shock proteins