A study of serum androgen and cortisol levels in female patients with rheumatoid arthritis. Correlation with disease activity

Summary Androgen status and the role played by androgens in the pathogenesis of rheumatoid arthritis (RA) in female patients are a matter of debate. In the present study serum testosterone (T), DHEAS, sex hormone binding globulin (SHBG) and cortisol levels were determined in 55 RA women, both in pre- and post-menopausal (M) status, and in a group of healthy subjects. Patients were divided into two groups according to disease activity and a correlation analysis of hormonal levels against serum IL1 levels was performed. No significant differences were found in serum T levels between RA patients and controls, both in preM (1.38±0.4 vs 1.35±0.3 nmol/l; p=ns) and in postM status (1.21±0.2 vs 1.10±0.2 nmol/l; p=ns). Serum SHBG levels were lower in RA patients than in control subjects, both in pre and in postM status. DHEAS levels were significantly lower in preM RA patients than in controls (2.34±1.2 vs 5.93±1.6 µmol/l; p<0.001) while cortisol levels were significantly higher in preM active RA patients than in controls (466.2±30.3 vs 411±66.2 nmol/l; p=0.02). IL1 levels were significantly higher in RA patients than in controls both in pre- and postM subjects (70±33.8 vs 23.1±2.9 and 92±27.4 vs 31.9±3.1 fmol/l, p<0.001, respectively).Although androgen status could play a role in the pathogenesis of RA, at present it is not possible to exclude the influence of RA itself on sex hormone profile.     

Th-17 cells and serum IL-17 in rheumatoid arthritis patients: Correlation with disease activity and severity

Aim of the workTo investigate the role of T-helper 17 (Th17) cells in peripheral blood and serum interleukin-17 (IL-17) in rheumatoid arthritis (RA) patients, and their correlation with disease activity and joint destruction.Patients and methodsThis study included forty RA patients and twenty matched healthy controls. Disease activity score in 28 joints (DAS-28), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-CCP, tumor necrosis factor alpha (TNF-α), serum IL-17 and Th17 cells in peripheral blood were measured. Radiological assessment using modified Sharp/van der Heijde (mSvH) score for hand and feet in addition to MRI score for the wrist and metacarpophalangeal (MCP) joints were performed for detection of synovitis and bone erosion.ResultsThe patients were 38 females and 2 males with a mean of 41.15 ± 5.85 years and disease duration of 15.6 ± 4.62 years. Serum IL-17 and Th17 cells in peripheral blood were found to be significantly increased in RA patients (204.1 ± 33.8 pg/ml and 4.62 ± 1.13%) than in controls (25.36 ± 5.39 pg/ml and 0.7 ± 0.021%) (p < 0.001). Th17 cells significantly correlated with serum IL-17 (r 0.88, p < 0.001). Both Th17 cells and serum IL-17 significantly correlated with DAS-28, ESR, CRP, TNF-α, Van der Heijde modification score and MRI scores for wrist and MCP joints for synovitis and bone erosion (all with a p < 0.001).ConclusionThis study demonstrates an important role for Th-17 cells and serum IL-17 in the pathogenesis of the inflammatory and destructive pattern characteristic of RA.     

Correlation between rheumatoid factor and IL-6 activity in synovial fluids from patients with rheumatoid arthritis

Synovial fluids (SF) and sera (S) from patients with rheumatoid arthritis (RA) were examined for IgM, IgM-rheumatoid factor (IgM-RF), albumin and interleukin-6 (IL-6) activity. The quotient of SF/S IgM-RF was elevated compared with that of SF/S albumin in 7 patients with seropositive RA, although the quotient of SF/S IgM was lower than that of SF/S albumin. SF IL-6 activity was much higher than serum IL-6 activity in all the 7 RA patients. In synovial fluids from 22 seropositive RA patients, SF IL-6 activity was significantly correlated with the SF IgM-RF, IgG-RF and IgA- less than RF, but not with SF IgM, IgG or IgA. Moreover, SF IgM-RF as well as SF IL-6 activity was significantly correlated with the Westergren erythrocyte sedimentation rate (ESR) or the Lansbury articular index. These results indicate that IL-6 and RF might be produced within the rheumatoid joints as a result of abnormal immune system activation, which is associated with the disease activity of RA. Three of the 4 seronegative RA patients, however, showed high SF IL-6 without detectable levels of SF IgM-RF, indicating that IL-6 alone is not sufficient for IgM-RF production.     

Correlation of CRP genotypes with serum CRP levels and the risk of rheumatoid arthritis in Chinese Han population

Clinical Rheumatology - C-reactive protein (CRP) is an important index for evaluating the disease activity of rheumatoid arthritis (RA). CRP may play a direct role in bone destruction in RA....     

ACTH,cortisol and prolactin in active rheumatoid arthritis

Prolactin (PRL) and glucocorticoids are hormones involved in the regulation of the immune system. Rheumatoid arthritis (RA) is an inflammatory condition that presents a diurnal rhythm of disease activity. ACTH, PRL, cortisol, IL-1β and TNF-α circadian rhythms have been studied in active RA (aRA) to evaluate a possible relationship between the neuroendocrine system and immunological activity in rheumatoid patients. ACTH, PRL, cortisol, PRL/cortisol ratio and IL-1β and TNF-α levels were determined in aRA patients and in control subjects at 6.00, 10.00, 14.00, 18.00, 22.00 and 02.00 h. In aRA patients we observed lower ACTH and cortisol levels at 22.00 h and 2.00 h, respectively and higher PRL and PRL/cortisol ratio at 2.00 h when compared to controls. IL-1β and TNF-α reached their highest serum levels in aRA patients at 2.00 and 6.00 h. This study provides evidence that in aRA there could be a temporary and probably causal relationship between diurnal disease activity, hormonal disequilibrium and cytokine secretion. An imbalance in favour of proinflammatory hormones (PRL and cytokines) as opposed to levels of anti-inflammatory hormones could be responsible for the diurnal rhythm of activity disease observed in aRA patients. Received: 26 February 2001 / Accepted: 28 January 2002     

Correlation of serum levels of adenosine deaminase activity and its isoenzymes with disease activity in rheumatoid arthritis

OBJECTIVE: Adenosine deaminase (ADA) is involved in purine metabolism and plays a significant role in the mechanisms of the immune system. The aim of this study was to investigate the correlation between the activity of total ADA (tADA) and isoenzymes ADA1 and ADA2 and clinical activity in patients with rheumatoid arthritis (RA). METHODS: The study comprised 37 patients with rheumatoid arthritis and 30 healthy controls. Total serum ADA activity was measured spectrophotometrically. The isoenzyme pattern of ADA was analyzed using erytro-9-(2-hydroxy-3-nonyl) adenine (EHNA). Disease activity was assessed using DAS criterion. RESULTS: The means of tADA, ADA1 and ADA2 levels were found to be 22.7 +/- 5.9, 3.9 +/- 2.0 and 18.8 +/- 4.9 IU/L in patients with RA, and 15.1 +/- 4.4, 4.1 +/- 1.2 and 11.0 +/- 3.7 IU/L in healthy control subjects. When compared to the healthy controls, serum tADA and ADA2 levels were significantly higher (p < 0.001) in patients with RA, but the decrease of ADA1 level was not statistically significant (p > 0.05). There was a strong correlation (r = 0.527, p < 0.001) between serum tADA level and disease activity by DAS (Pearson's rank correlation), and no correlation between tADA and CRP or ESR in the patient groups (p > 0.05). CONCLUSION: Serum tADA and ADA2 activity is closely associated with RA and these non-invasive investigations can be used as biochemical markers for inflammation. These may provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.     

慢性阻塞性肺疾病急性加重期患者血脂水平与PCT IL-6和CRP含量的相关性研究

目的研究慢性阻塞性肺疾病急性加重期(AECOPD)患者的血脂水平与炎症因子的相关性。方法选择2018-03～2019-03住院治疗的AECOPD患者152例,根据有无呼吸衰竭分为呼吸衰竭组62例和非呼吸衰竭组90例。呼吸衰竭组均为Ⅱ型呼吸衰竭。检测两组患者的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、降钙素原(PCT)、白介素-6(IL-6)、C反应蛋白(CRP)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、第1秒用力呼气容积占预计值百分比(FEV1/pred)和第1秒用力呼气容积/用力肺活量(FEV1/FVC)相关指标并对比分析。采用Pearson相关性分析分析患者炎症因子、血脂水平与血气、肺功能指标相关性以及血脂水平与炎症因子的相关性。结果呼吸衰竭组血清炎症因子PCT、IL-6、CRP、血气指标PaCO_2水平均显著高于非呼吸衰竭组,差异有统计学意义(P0.01);呼吸衰竭组血脂水平TC、TG、HDL-C、血气指标PaO_2、肺功能指标FEV1/pred、FEV1/FVC均显著低于非呼吸衰竭组,差异有统计学意义(P0.01),两组LDL-C差异无统计学意义(P0.05)。Pearson相关性分析结果显示,AECOPD患者PCT、IL-6、CRP与PaO_2、FEV1/pred、FEV1/FVC呈显著负相关性(P0.001),与PaCO_2呈显著正相关性(P0.001);血脂TC、TG、HDL-C与PaO_2、FEV1/pred、FEV1/FVC呈正相关性(P0.05),与Pa CO_2呈负相关性(P0.05)。LDL-C与PaO_2、PaCO_2、FEV1/pred、FEV1/FVC相关性很低(P0.05);TC、TG、HDL-C与PCT、IL-6、CRP均呈显著负相关性(P0.001),LDL-C与PCT、IL-6、CRP相关性很低(P0.05)。结论AECOPD患者炎症因子明显升高,血脂TC、TG、HDL-C水平明显降低,血脂水平与炎性因子呈负相关性,提示两者水平变化可反映患者病情严重程度。     

冠心病患者IL-6及CRP血清水平检测的临床意义

目的 探讨白细胞介素-6(IL-6)血清水平和C-反应蛋白(CRP)在监测冠心病病情及与冠状动脉病变程度的关系.方法 142例冠心病患者,按临床诊断分为急性心肌梗死(AMI)组48例、不稳定性心绞痛(UAP)组45例、稳定性心绞痛(SAP)组49例,对照组50例.采用免疫透射比浊测定CRP,用酶联免疫吸附实验检测血清IL-6的水平.比较各组间的差异.结果 AMI组、UAP组及SAP组的CRP及IL-6水平均比对照组高(P<0.05);AMI组、UAP组ClIP及IL-6水平和SAP组相比,其值增加明显;AMI组和UAP组结果相似;IL-6水平与CRP变化呈正相关.结论 血清CRP及IL-6可能是冠状动脉粥样硬化的标志,参与了冠心病的发病过程,其值与冠状动脉病变程度密切相关.     

Plasma soluble IL-6 receptor concentration in rheumatoid arthritis: associations with the rs8192284 IL6R polymorphism and with disease activity

Soluble interleukin-6 receptor α subunit (sIL-6R) is primarily generated by shedding of the membrane-bound form. This process is influenced by the single nucleotide polymorphism rs8192284 (A > C) resulting in an aspartic acid to alanine substitution (D358A) at the proteolytic cleavage site. The aim of this study was to determine whether plasma levels of sIL6R are influenced by the rs8192284 polymorphism in patients with rheumatoid arthritis and to assess the association between plasma sIL-6R levels and disease activity as reflected by anti-CCP status. Thirty-nine patients were randomly selected from a cohort of patients with RA of Spanish descent. Plasma sIL-6R concentrations were measured using sandwich ELISA. Genotyping of the rs8192284 (A > C) polymorphism was done using a Fast Real-Time PCR System. DAS 28 scores were used to assess disease activity. Plasma sIL-6R levels were positively associated with the number of C alleles (AA: 35.27 (3.50) ng/ml, AC: 45.50 (4.58) ng/ml, CC: 52.55 (3.18) ng/ml, P = 0.0001). DAS28 and plasma sIL-6R levels were positively associated in the anti-CCP-positive subgroup (r ² = 0.45, P = 0.0336) and negatively associated in the anti-CCP-negative subgroup (r ² = −0.45, P = 0.0825). No association between anti-CCP status and sIL-6R level was found. Our findings show that the rs8192284 polymorphism is operative in patients with RA. The presence of anti-CCP antibodies determines the relationship between sIL-6R concentration and disease activity.     

类风湿关节炎患者白细胞介素-6与皮质醇节律的研究

目的：研究类风湿关节炎（RA）患者血清白细胞介素（IL）－6、皮质醇节律及其临床意义。方法：36例RA患者分别为8：00，12：00，16：00，20：00，0：00，4：00用双抗体夹心酶联免疫吸附试验（ELISA）检测其血清IL－6水平，用放射免疫法（RIA）测定皮质醇。结果：36例RA患者皮质醇分泌有明显节律，但与正常对照组相比，其峰值提前，出现于凌晨4点，血清IL－6水平高于对照组（P＜0．01），也存在昼夜节律，IL－6峰值出现在皮质醇峰值之前，经治疗病情稳定后，RA患者血清IL－6水平恢复或接近正常，IL－6与皮质醇节律紊乱得以纠正，相关性分析显示，RA患者血清IL－6水平与血沉（ESR）（P＜0．01，r=0.66)，C反应蛋白（CRP）（P＜0．01，r＝0.71)皮质醇（P＜0．05，r=0.58)呈正相关，结论：RA患者血清IL－6增高，IL－6与皮质醇存在昼夜节律紊乱，这些变化在RA的发病机制中可能具有重要意义。     

C-反应蛋白白细胞介素-6和肿瘤坏死因子-α在冠心病中的变化

目的 :探讨炎症标记物与冠心病的关系及临床意义。方法 :选择健康体检者 (正常对照组 ) 30例、稳定型心绞痛 (SAP组 )患者 2 0例、不稳定型心绞痛 (UAP)患者 2 5例和急性心肌梗死 (AMI)患者 30例 ,分别测定血清中C 反应蛋白 (CRP)、白细胞介素 6 (IL 6 )和肿瘤坏死因子 α(TNF α)的浓度。结果 :①SAP、UAP、AMI与正常对照组比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (均P <0 .0 1) ;②UAP与SAP比较 ,血清中CRP、TNF α均显著增高 (P <0 .0 1) ,但与IL 6比较差异无统计学意义 ;③AMI与SAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 1) ;④AMI与UAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 5 ) ;⑤血清中CRP、IL 6、TNF α在AMI发病的 72h以内有明显动态变化。结论 :炎症参与了冠心病的发病过程 ,血清中炎症因子水平的高低与冠心病的严重程度有关 ,AMI时炎症因子的动态演变可以作为病情稳定性的指标 ,对判断病情和预后具有临床价值。