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Serum and synovial cartilage oligomeric matrix protein levels in early and established rheumatoid arthritis

Oligomeres Knorpelmatrixprotein in Serum und Synovialflüssigkeit – Konzentrationen bei früher und etablierter rheumatoider Arthritis

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Abstract

Objective

To assess cartilage oligomeric matrix protein (COMP) levels in serum and synovial fluid in patients with early and established rheumatoid arthritis (RA), and to correlate the levels with clinical, laboratory and radiological characteristics.

Patients and methods

The study included 24 female RA patients. Full medical history was taken, thorough clinical examination and laboratory investigations performed, and body mass index (BMI) recorded. Radiological damage was assessed according to the modified Larsen score. Disease activity score 28 (DAS28) was calculated. The control group comprised 30 age- and gender-matched healthy subjects. Serum and synovial COMP levels were determined by enzyme-linked immunosorbent assay (ELISA).

Results

Mean patient age was 44.04 ± 10.5 years. Of the 24 patients, 12 had early RA and 12 had established disease with joint destruction; 5 of each group had knee effusion. Serum COMP was significantly higher in patients (19.54 ± 5.47 µg/ml) compared to controls (5.93 ± 1.95 µg/ml; p < 0.001) and was also significantly higher in patients with established disease (23.9 ± 3.1 µg/ml) compared to those in early stages (15.1 ± 3.2 µg/ml; p < 0.001). Synovial COMP was also significantly increased in established compared to early-stage RA (31.2 ± 9.8 µg/ml vs. 51.6 ± 10.4 µg/ml; p = 0.013). Serum and synovial COMP significantly correlated with age, disease duration, BMI, DAS28 and modified Larsen score. On performing regression analysis in RA patients, only BMI could predict the serum level of COMP (p = 0.02).

Conclusion

COMP is a promising biomarker for disease activity in RA, making it a potential therapeutic target. The obvious correlation with the BMI throws light on the importance of weight control not only in osteoarthritis (OA), but also in RA.

Zusammenfassung

Ziel

Die COMP(oligomeres Knorpelmatrixprotein)-Konzentrationen im Serum und in der Synovialflüssigkeit von Patienten mit früher und mit etablierter rheumatoider Arthritis (RA) sollten bestimmt und auf mögliche Beziehungen zu klinischen, laborchemischen und radiologischen Charakteristika untersucht werden.

Patienten und Methoden

In die Studie aufgenommen wurden 24 RA-Patienten. Eine ausführliche Anamnese wurde erhoben, gründliche klinische und laborchemische Untersuchungen wurden durchgeführt und der BMI (Body-Mass-Index) dokumentiert. Radiologisch sichtbare Schädigungen wurden bestimmt anhand des modifizierten Larsen-Scores, der DAS (Disease Activity Score) 28 wurde errechnet. Die Kontrollgruppe bestand aus 30 alters- und geschlechtsgematchten gesunden Personen. Serum- und synoviale COMP-Konzentrationen wurden mittels ELISA („enzyme-linked immunosorbent assay“) gemessen.

Ergebnisse

Das Durchschnittsalter der Patienten lag bei 44,04 ± 10,5 Jahren. Von 24 Patienten litten 12 an früher und 12 an etablierter RA mit Gelenkzerstörung, einen Kniegelenkerguss hatten jeweils 5 Patienten in jeder Gruppe. COMP im Serum war in der Patientengruppe höher als in der Kontrollgruppe (19,54 ± 5,47 vs. 5,93 ± 1,95 µg/ml; p < 0,001) und auch signifikant höher bei Patienten mit länger bestehender Erkrankung (23,9 ± 3,1 µg/ml) im Vergleich zu denen mit RA in frühen Stadien (15,1 ± 3,2 µg/ml; p < 0,001). Im Vergleich zu letztgenannten waren auch die synovialen COMP-Konzentrationen signifikant erhöht bei Patienten mit etablierter RA (31,2 ± 9,8 vs. 51,6 ± 10,4 µg/ml; p = 0,013). Serum- und synoviale COMP-Konzentrationen korrelierten signifikant mit Alter, Erkrankungsdauer, BMI, DAS28 und modifiziertem Larsen-Score. Die Regressionsanalyse der RA-Patienten-Werte ergab, dass eine Vorhersage der Serum-COMP-Werte nur anhand des BMI möglich war (p = 0,02).

Schlussfolgerung

COMP ist ein viel versprechender Biomarker für die Krankheitsaktivität bei RA und damit ein potenzielles therapeutisches Target. Die offensichtliche Korrelation mit dem BMI wirft ein Schlaglicht darauf, wie entscheidend die Kontrolle des Körpergewichts ist – nicht nur bei Arthrose, sondern auch bei RA.

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Compliance with ethical guidelines

Conflict of interest. A.O. El Defrawy, T.A Gheita, H.M Raslan, M.M El Ansary and A.H El Awar state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Internal Medicine Department, National Research Centre, -, Egypt

    A.O. El Defrawy & H.M. Raslan

  2. Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    T.A. Gheita M.D. & A.H. El Awar

  3. Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    M.M. El Ansary

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  1. A.O. El Defrawy
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  2. T.A. Gheita M.D.
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Correspondence to T.A. Gheita M.D..

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El Defrawy, A., Gheita, T., Raslan, H. et al. Serum and synovial cartilage oligomeric matrix protein levels in early and established rheumatoid arthritis. Z Rheumatol 75, 917–923 (2016). https://doi.org/10.1007/s00393-015-1647-5

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  • DOI: https://doi.org/10.1007/s00393-015-1647-5

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