－S 378 －
￭ ♣S-631 ￭
CXCL2 as a potential biomarker of disease activity in rheumatoid arthritis
1Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, 2Department of Cell and Developmental Biology, BK21 and DRI, Seoul National University School of Dentistry
*Kichul Shin1, Ji Ah Park1, Jun Wan Kim1, Hong Hee Kim2, Eun Bong Lee1, Yeong Wook Song1
Background: The diverse role of chemokines in rheumatoid arthritis (RA) includes enhancement of leukocyte migration, and angiogenesis in the synovium. CXCL2 is a chemokine produced by activated macrophages and acts as a mediator for chemotaxis of neutrophils, regulation of transmigration and extravascular tissue accumulation of leukocytes. We recently demonstrated that CXCL2 contributes in osteoclastogenesis and bone erosion in vivo. In this study, we investigated the relationship between serum CXCL2 concentration and clinical and radiological parameters in RA patients. Methods: Eighty one RA patients who visited the rheumatology clinic participated in this study. All patients fulfilled the 1987 ACR classification criteria for RA. Serum CXCL2, CRP levels and blood ESR were measured. Clinical parameters including DAS28, visual analog scale (VAS) of physician’s and patient’s global assessment, pain, fatigue, and health assessment questionnaire (HAQ) score as well as simple erosion narrowing score (SENS) were evaluated at the time point obtaining the samples. In additional 19 patients treated with infliximab, sera at pre- and post-treatment (5 infusions) were obtained. Results: Demographic data of 81 RA patients (female ratio 79%) showed age of 51.8±14.5 (mean±S.D.)years, disease duration of 9.7±8.0 years, and DAS28(ESR) of 4.8±1.8. The serum level of CXCL2 in RA patients vs. healthy controls was 963.3±42.1 vs. 505.0±40.7 pg/mL (p=0.002) respectively. Among the clinical parameters, a positive correlation was shown between DAS28(ESR) and CXCL2 levels (r=0.235, p=0.035). ESR and CRP levels also showed positive correlation with CXCL2 (r=0.310, p=0.005 and r=0.540, p<0.001, respectively). SENS did not correlate with CXCL2 levels. Serum CXCL2 levels tended to decrease compared with baseline in 19 RA patients after receiving 5 infusions of infliximab (p=0.055). Conclusion: Serum CXCL2 levels correlated well with DAS28 (ESR), and ESR, CRP levels in RA patients. CXCL2 may be a potential biomarker of disease activity of RA.
￭ ♣S-632 ￭
Risk factors for carotid plaques in Korean patients with rheumatoid arthritis
Department of Internal Medicine, Kyungpook National University School of Medicine
*Ji Hun Kim, Na Ri Kim, Jong Wan Kang, Jin Young Kang, Churl Hyun Im, Eon Jeong Nam, Young Mo Kang
Purpose: Cardiovascular disease (CVD) prevalence and mortality are elevated in rheumatoid arthritis (RA) patients as much as those of type 2 diabetes patients. The aim of this study was to estimate the risk factors for subclinical carotid atherosclerosis in Korean patients with RA.
Methods: We studied 165 consecutive RA patients of Asian Korean descent who were followed by rheumatologists at a single center.
Extensive sets of cinical risk factors including demographic characteristics, medical and family histories, life style factors, metabolic parameters, and disease activity and severity, were ascertained. Mean and maximal intima-media thickness (IMT) and carotid plaques were identified using carotid duplex sonography. The number of plaques at carotid arteries of both sides was determined. Results: The study population included 126 females and 39 males. Carotid plaques were observed in 60 (38.2%) of patients. Significant associations with carotid plaque were found at medical histories (diabetes and osteoporosis), life style characteristics (cigarette smoking and alcohol intake), metabolic parameters (homocysteine, HOMA-IR, and waist-hip ratio (WHR)), and RA-related factors (onset age, functional class, Korean version of modified healthy assessment questionnaire (mKHAQ), tender/swollen joint counts (TJC/SJC), pain VAS, patients/physician’s global assessments, ESR, c-reactive protein (CRP), DAS28, and rheumatoid factor titer), as well as at demographic characteristics. The number of plaques was significantly correlated with age, smoking, homocysteine, WHR, DAS, EAR, CRP, and IMT. As determined by univariate analysis with adjustment for age and sex, smoking, mKHAQ, DAS28, patient/physician’s global assessments, and ESR were still significantly associated with carotid plaque.
In multivariate analysis, the factors that were significantly associated with carotid plaque were age, smoking, mKHAQ, and ESR. Conclusions:
The present data demonstrated that factors representing the activity and severity of arthritis contributed to the development of carotid plaque independent of conventional risk factors in Asian Korean patients with RA.
