Circulating adipokines and organ involvement in patients with systemic sclerosis.

BACKGROUND: In recent years, mediators synthesized in the adipose tissue, the so-called adipokines, have been reported to play important roles in the pathogenesis of autoimmune rheumatic diseases. OBJECTIVE: To compare serum leptin, adiponectin and resistin levels in patients with systemic sclerosis (SSc) and healthy controls. To find possible relationship between serum levels of adipokines and organ involvement with focus on interstitial lung disease in SSc patients. PATIENTS AND METHODS: Lung involvement was assessed functionally (body plethysmography, diffusing capacity of the lung for carbon monoxide (DLCO) and six-minute walk test) and radiologically (using average disease extent on high resolution computed tomography (HRCT) of the lungs according to the percentage of interstitial changes) in 29 SSc patients. Quantitative sandwich ELISA was used to measure resistin, leptin and adiponectin concentrations in sera of patients and 30 healthy controls. RESULTS: We found no statistically significant differences in serum resistin, leptin and adiponectin levels between SSc patients and the controls. However, serum adiponectin concentrations were significantly lower in active than in inactive patients, they also correlated positively with vital capacity (VC) (p=0.04) and negatively with Valentini activity score (p=0.04). Serum resistin levels were significantly elevated in patients with digital ulcers (p=0.03) and serum concentrations of leptin were associated with the duration of SSc symptoms other than Raynaud's phenomenon (p<0.01) CONCLUSIONS: Serum adiponectin should be further investigated as a candidate for SSc activity marker and resistin may play a role in ulcer development in SSc patients.

Blood serum levels of amino-terminal pro-C-type natriuretic peptide in patients with rheumatoid arthritis.

PURPOSE: Angiogenesis is a prominent feature of rheumatoid synovitis and contributes to perpetuation of joint disease. The aim of presented study was to evaluate the association of inflammatory response and endothelial dysfunction parameters with serum levels of amino-terminal pro-C-type natriuretic peptide (NT-proCNP), a surrogate measure for a potent regulator of vascular tone and angiogenesis, CNP. MATERIAL/METHODS: We included in this study 40 rheumatoid arthritis (RA) patients (36 female, four male) and 30 healthy controls (28 female, two male). Disease activity score (DAS28), Health Assessment Questionnaire Disability Index (HAQDI), Rheumatoid Arthritis Disease Activity Index (RADAI) and visual analogue scales (VAS) for pain and arthritis were determined. The concentrations of the following laboratory parameters (serum C-reactive protein (CRP), soluble (s) L-, sP-, sE-selectin, NT-proCNP, IgM rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibodies) were measured using sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: The concentrations of NT-proCNP in RA patients were significantly increased when compared to healthy controls (p<0.001). In RA patients we found significant correlations only between sE-selectin and NT-proCNP levels (p=0.02). No significant associations were found between serum NT-proCNP and soluble selectin levels and patients' age and sex. Also, the parameters of clinical profile in the RA group (HAQ, RADAI, DAS28, VAS-pain, VAS-arthritis, swollen and tender joint counts) showed no association with serum NT-proCNP, sE-, sP- and sL-selectin. CONCLUSIONS: Serum concentration of NT-proCNP reflecting serum CNP level is likely secondary to the activation of endothelium. Nevertheless, the results of our study encourage to further studies over the role of CNP in the pathogenesis of RA, preferably on tissue level.