Abstract
Rheumatoid arthritis (RA) is a condition that is associated with oxidative stress. Serum trace elements and their related transport proteins, e.g., albumin and ceruloplasmin, play an important role in the antioxidant defense. Trace element status may therefore be involved in the pathogenesis of RA or be affected by the disease activity of this chronic inflammatory condition. The study participants were 110 patients with RA and 100 sex- and age-matched healthy volunteers. Serum concentrations of albumin, ceruloplasmin, selenium, zinc, copper, and zinc/copper ratio were measured in all subjects. The relationship between these parameters and disease activity score was also assessed. Lower concentrations of serum Alb, Zn, and Se were independently related to disease activity index. High concentrations of serum copper were associated with the presence of RA. Serum Cu concentrations were positively related to disease activity as assessed by the disease activity score. Low serum concentrations of Zn and Se, and high serum Cu concentrations may be associated with the presence of RA or be a consequence of this condition. Of the trace elements that were investigated in the present study, only serum Cu was positively correlated with disease activity.
Similar content being viewed by others
References
Ala S, Shokrzadeh M, Pur SA, Saeedi SS (2009) Zinc and copper plasma concentrations in rheumatoid arthritis patients from a selected population in Iran. Pakistan Journal of Biological Sciences: PJBS 12:1041
Stejskal V, Reynolds T, Bjørklund G (2015) Increased frequency of delayed type hypersensitivity to metals in patients with connective tissue disease. Journal of Trace Elements in Medicine and Biology 31:230–236. doi:10.1016/j.jtemb.2015.01.001
Afridi HI, Kazi TG, Brabazon D, Naher S (2011) Association between essential trace and toxic elements in scalp hair samples of smokers rheumatoid arthritis subjects. Science of the Total Environment 15:412–413. doi:10.1016/j.scitotenv.2011.09.033
Cooles FA, Isaacs JD (2011) Pathophysiology of rheumatoid arthritis. Current Opinion in Rheumatology 23(3):233–240. doi:10.1097/BOR.0b013e32834518a3
McInnes IB, Schett G (2011) The pathogenesis of rheumatoid arthritis. New England Journal of Medicine 365(23):2205–2219. doi:10.1056/NEJMra1004965
Choy E (2012) Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology 51:v3–v11. doi:10.1093/rheumatology/kes113
Lukey PT, Perry HC, Yang S, Parry S, Dickson MC, Norris VH, Russell PG, Watissée M, Rioja I, Ray KP (2012) Single doses of p38 MAP kinase inhibitors or prednisolone affect CRP and IL-6 in patients with active rheumatoid arthritis (RA). Open Journal of Immunology 52(3):187–198. doi:10.1007/s40262-012-0025-6
Yoshida, K., Hashimoto, T., Sakai, Y., Hashiramoto, A. (2014). Involvement of the circadian rhythm and inflammatory cytokines in the pathogenesis of rheumatoid arthritis. Journal of Immunology Research, 282495. doi: 10.1155/2014/282495.
Rho YH, Chung CP, Oeser A, Solus JF, Gebretsadik T, Shintani A, Raggi P, Milne GL, Stein CM (2010) Interaction between oxidative stress and high-density lipoprotein cholesterol is associated with severity of coronary artery calcification in rheumatoid arthritis. Arthritis Care & Research 62(10):1473–1480. doi:10.1002/acr.20237
Hitchon CA, El-Gabalawy HS (2004) Oxidation in rheumatoid arthritis. Arthritis Research & Therapy 6(6):265–278
Long FXDJS, Baocaidan G (2013) Tibetan medicine bath on the treatment of rheumatoid arthritis in the human body changes in trace element analysis. Journal of Medicine & Pharmacy of Chinese Minorities 3:007
Negi R, Pande D, Karki K, Kumar A, Khanna RS, Khanna HD (2012) Trace elements and antioxidant enzymes associated with oxidative stress in the pre-eclamptic/eclamptic mothers during fetal circulation. Clinical Nutrition 31(6):946–950. doi:10.1016/j.clnu.2012.04.005
Imlay JA, Linn S (1988) DNA damage and oxygen radical toxicity. Science 3(4857):1302–1309
Assumpção TC, Ma D, Schwarz A, Reiter K, Santana JM, Andersen JF, Ribeiro JM, Nardone G, Lee LY, Francischetti IM (2013) Salivary antigen-5/CAP family members are Cu2 + -dependent antioxidant enzymes that scavenge O2⨪ and inhibit collagen-induced platelet aggregation and neutrophil oxidative burst. Journal of Biological Chemistry 288(20):14341–14361. doi:10.1074/jbc.M113.466995
Wang CH, Dai JY, Wang L, Jia JF, Zheng ZH, Ding J, Chen ZN, Zhu P (2011) Expression of CD147 (EMMPRIN) on neutrophils in rheumatoid arthritis enhances chemotaxis, matrix metalloproteinase production and invasiveness of synoviocytes. Journal of Cellular and Molecular Medicine 15(4):850–860. doi:10.1111/j.1582-4934.2010.01084.x
Bonaventura P, Benedetti G, Albarède F, Miossec P (2015) Zinc and its role in immunity and inflammation. Autoimmunity Reviews 14(4):277–285. doi:10.1016/j.autrev.2014.11.008
Taneja SK, Mandal R (2009) Assessment of mineral status (Zn, Cu, Mg and Mn) in rheumatoid arthritis patients in Chandigarh, India. Rheumatology Reports 1:e5. doi:10.4081/rr.2009.e5
McInnes IB, Schett G (2007) Cytokines in the pathogenesis of rheumatoid arthritis. Nature Reviews Immunology 7(6):429–442
O'Dell JR, Lemley-Gillespie S, Palmer WR, Weaver AL, Moore GF, Klassen LW (1991) Serum selenium concentrations in rheumatoid arthritis. Annals of the Rheumatic Diseases 50(6):376–378
Grisar J, Aletaha D, Steiner CW, Kapral T, Steiner S, Seidinger D, Weigel G, Schwarzinger I, Wolozcszuk W, Steiner G (2005) Depletion of endothelial progenitor cells in the peripheral blood of patients with rheumatoid arthritis. Circulation 111(2):204–211
A.M. (1983). Carlsson, assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 16(1):87-101.
Malaviya AN (2003) Outcome measures in rheumatoid arthritis. APLAR Journal of Rheumatology 6:178–183. doi:10.1046/j.0219-0494.2003.00043
Jou J, Lewis S, Briggs C, LEE SH, De La Salle B, McFadden S (2011) ICSH review of the measurement of the erythocyte sedimentation rate. International Journal of Laboratory Hematology 33(2):125–132. doi:10.1111/j.1751-553X.2011.01302.x
Thomas RD, Westengard JC, Hay KL, Bull BS (1993) Calibration and validation for erythrocyte sedimentation tests. Role of the international committee on standardization in hematology reference procedure. Archives of Pathology & Laboratory Medicine 117(7):719–723
Ghayour-Mobarhan M, Taylor A, New SA, Lamb DJ, Ferns GA (2005) Determinants of serum copper, zinc and selenium in healthy subjects. Annals of Clinical Biochemistry 42(Pt 5):364–375
Ghayour-Mobarhan M, Shapouri-Moghaddam A, Azimi-Nezhad M, Esmaeili H, Parizadeh SM, Safarian M, Kazemi-Bajestani SM, Khodaei GH, Hosseini SJ, Parizadeh SM, Ferns GA (2009) The relationship between established coronary risk factors and serum copper and zinc concentrations in a large Persian cohort. Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS) 23(3):167–175. doi:10.1016/j.jtemb.2009.03.006
Parizadeh SMR (2011) Serum zinc and copper concentrations and socioeconomic status in a large Persian cohort. Asian Biomedicine (Research Reviews and News) 5:329–335
Blom M, Hjørne N (1975) Immunochemical determination of serum albumin with a centrifugal analyzer. Clinical Chemistry 21(2):195–198
Dupont WD, Plummer WD (1990) Power and sample size calculations: a review and computer program. Controlled Clinical Trials 11(2):116–128
Mikuls TR, O'Dell JR, Stoner JA, Parrish LA, Arend WP, Norris JM, Holers VM (2004) Association of rheumatoid arthritis treatment response and disease duration with declines in serum levels of IgM rheumatoid factor and anti-cyclic citrullinated peptide antibody. Arthritis and Rheumatism 50(12):3776–3782
Anderson JJ, Wells G, Verhoeven AC, Felson DT (2000) Factors predicting response to treatment in rheumatoid arthritis: the importance of disease duration. Arthritis and Rheumatism 43(1):22–29
Frisell T, Hellgren K, Alfredsson L, Raychaudhuri S, Klareskog L, Askling J (2014) Familial aggregation of arthritis-related diseases in seropositive and seronegative rheumatoid arthritis: a register-based case-control study in Sweden. Annals of the Rheumatic Disease. doi:10.1136/annrheumdis-2014-206133
Masi AT, Shulman LE (1965) Familial aggregation and rheumatoid disease. Arthritis & Rheumatism 8:418–425
Michiels C, Raes M, Toussaint O, Remacle J (1994) Importance of Se-glutathione peroxidase, catalase, and Cu/Zn-SOD for cell survival against oxidative stress. Free Radical Biology and Medicine 17(3):235–248
Rotruck J, Pope A, Ganther H, Swanson A, Hafeman DG, Hoekstra W (1973) Selenium: biochemical role as a component of glutathione peroxidase. Science 179(4073):588–590
Das U (1998) Oxidants, anti-oxidants, essential fatty acids, eicosanoids, cytokines, gene/oncogene expression and apoptosis in systemic lupus erythematosus. The Journal of the Association of Physicians of India 46(7):630–634
Seyrek A, Kocyigit A, Erel O (2005) Essential trace elements selenium, zinc, copper, and iron concentrations and their related acute-phase proteins in patients with vivax malaria. Biological Trace Element Research 106(2):107–115
Menkes C-J (1993) Effects of disease-modifying anti-rheumatic drugs, steroids and non-steroidal anti-inflammatory drugs on acute-phase proteins in rheumatoid arthritis. Rheumatology 3:14–18
Ballantyne FC, Fleck A, Dick WC (1971) Albumin metabolism in rheumatoid arthritis. Annals of the Rheumatic Diseases 30(3):265–270
Yazar M, Sarban S, Kocyigit A, Isikan U (2005) Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis. Biological Trace Element Research 106(2):123–132
Önal S, Nazıroğlu M, Çolak M, Bulut V, Flores-Arce MF (2011) Effects of different medical treatments on serum copper, selenium and zinc levels in patients with rheumatoid arthritis. Biological Trace Element Research 142(3):447–455. doi:10.1007/s12011-010-8826-7
Mussalo-Rauhamaa H, Konttinen YT, Lehto J, Honkanen V (1988) Predictive clinical and laboratory parameters for serum zinc and copper in rheumatoid arthritis. Annals of the Rheumatic Diseases 47(10):816–819
Weder JE, Dillon CT, Hambley TW, Kennedy BJ, Lay PA, Biffin JR, Regtop HL, Davies NM (2002) Copper complexes of non-steroidal anti-inflammatory drugs: an opportunity yet to be realized. Coordination Chemistry Reviews 232:95–126
Sahebari M, Abrishami-Moghaddam M, Moezzi A, Ghayour-Mobarhan M, Mirfeizi Z, Esmaily H, Ferns G (2014) Association between serum trace element concentrations and the disease activity of systemic lupus erythematosus. Lupus 23(8):793–801
Youssef A, Wood B, Baron D (1983) Serum copper: a marker of disease activity in rheumatoid arthritis. Journal of Clinical Pathology 36(1):14–17
Denko CW (1979) Protective role of ceruloplasmin in inflammation. Agents and Actions 9(4):333–336
Mohamed G, Arab S, Alshikh A (2013) Determination of some trace elements in blood of rheumatoid arthritis patients in some areas of Saudi Arabia kingdom. Life Science Journal 10(3)
Hong K, Kui X, Chen S, Jing L, Yi S, Shurong L, Liang Z, Shufang J, Longfu Z, Yonghe H (2013) Alylasis of five trace elements in serum of 512 patients with rheumatoid. International Journal of Laboratory Medicine 10(2013):008
Al-Rawi ZS, Gorial FI, Al-Shammary WA, Muhsin F, Al-Naaimi AS, Kareem SA (2013) Serum boron concentration in rheumatoid arthritis: correlation with disease activity, functional class, and rheumatoid factor. Journal of Experimental and Integrative Medicine 3(1):9–15. doi:10.5455/jeim.101112.or.053#_blank
Xin, L., Yang, X., Cai, G., Fan, D., Xia, Q., Liu, L., Hu, Y., Ding, N., Xu, S., Wang, L., Li, X., Zou, Y., Pan, F. (2015) Serum levels of copper and zinc in patients with rheumatoid arthritis: a Meta-analysis. Biology Trace Element Research.
Knoell DL, Julian MW, Bao S, Besecker B, Macre JE, Leikauf GD, DiSilvestro RA, Crouser ED (2009) Zinc deficiency increases organ damage and mortality in a murine model of polymicrobial sepsis. Critical Care Medicine 37(4):1380–1388. doi:10.1097/CCM.0b013e31819cefe4
Leone N, Courbon D, Ducimetiere P, Zureik M (2006) Zinc, copper, and magnesium and risks for all-cause, cancer, and cardiovascular mortality. Epidemiology 17(3):308–314
Borges MC, Dos Santos FDMM, Telles RW, Lanna CCD, Correia MIT (2012) Nutritional status and food intake in patients with systemic lupus erythematosus. Nutrition 28(11-12):1098–1103
Borges MC, Dos Santos FDMM, Telles RW, Lanna CCD, Correia MIT (2012) Nutritional status and food intake in patients with systemic lupus erythematosus. Nutrition 28(11-12):1098–1103. doi:10.1016/j.nut.2012.01.015
Arthur JR, McKenzie RC, Beckett GJ (2003) Selenium in the immune system. The Journal of Nutrition 133(5):1457S–1459S
Acknowledgments
This article was extracted from a dissertation of Dr. Razie Ayati with her thesis No. 2466-T submitted to the School of Medicine of Mashahd University of Medical Sciences in partial fulfillment of the requirement for the degree of the Doctor of Medicine [M.D]. The authors would like to acknowledge Research Council and School of Medicine of Mashhad University of Medical Sciences for their financial support [Grant No. 89355].
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sahebari, M., Ayati, R., Mirzaei, H. et al. Serum Trace Element Concentrations in Rheumatoid Arthritis. Biol Trace Elem Res 171, 237–245 (2016). https://doi.org/10.1007/s12011-015-0501-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12011-015-0501-6