Clinical Rheumatology

, Volume 37, Issue 4, pp 901–908 | Cite as

Serum substance P: an indicator of disease activity and subclinical inflammation in rheumatoid arthritis

  • Rosa Elda Barbosa-Cobos
  • Gustavo Lugo-Zamudio
  • Javier Flores-Estrada
  • Lizbeth Teresa Becerril-Mendoza
  • Pedro Rodríguez-Henríquez
  • Rubén Torres-González
  • Mario Adán Moreno-Eutimio
  • Julian Ramirez-Bello
  • José Moreno
Original Article


The aim of the is study is to examine the role of serum substance P (SP) levels as a simple biomarker for rheumatoid arthritis (RA) disease activity, its correlation with other markers of disease activity, and with selected clinical parameters. The study comprised 90 RA patients and 24 healthy controls. RA activity was assessed by means of the disease activity 28-C-reactive protein (DAS28-CRP) index and ultrasound power Doppler (USPD) by the German ultrasound score based on seven joints. SP serum values were obtained by means of an ELISA commercial kit. Statistics were achieved by the Student’s t test and Spearman correlation analysis with Bonferroni correction. As a group, RA patients had significantly increased levels of SP compared with healthy controls (p < 0.0001). SP levels correlated with DAS28-CRP (r = 0.5050, p < 0.0001), number of tender joints (NTJ, r = 0.4668, p < 0.0001), number of swollen joints (NSJ, r = 0.4439, p < 0.0001), visual analogue scale (VAS, r = 0.5131, p < 0.0001). However, SP did not correlate with CRP levels (r = 0.0468, p = 0.6613), nor with the USPD (r = 0.1740, p = 0.1009). Elevated serum SP is a common feature of RA patients, which also appears to correlate with clinical measurements of disease activity and with subjective clinical data (NTJ and VAS). Thus, although SP is higher in RA patients with high disease activity, it also detects subtle RA disease activity even in patients in apparent remission, which suggests its usefulness for therapeutic decisions.


Biomarker and C-reactive protein Disease activity Rheumatoid arthritis Substance P 



We acknowledge Dr. Julia Toscano-Garibay for valuable comments on the manuscript and Dr. Angelica Garcia-Martinez, from “Un kilo de ayuda A.C.” for in depth advice with statistic analysis. We thank the health professionals and nurses that facilitate our work at the Department of Rheumatology of the Hospital Juárez de México. We are deeply grateful to all patients and controls for their participation in this study. This work was supported by Hospital Juárez de México (HJM 2280/13-A).

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Rosa Elda Barbosa-Cobos
    • 1
  • Gustavo Lugo-Zamudio
    • 1
  • Javier Flores-Estrada
    • 2
  • Lizbeth Teresa Becerril-Mendoza
    • 1
  • Pedro Rodríguez-Henríquez
    • 3
  • Rubén Torres-González
    • 4
  • Mario Adán Moreno-Eutimio
    • 2
  • Julian Ramirez-Bello
    • 2
  • José Moreno
    • 2
  1. 1.Department of RheumatologyHospital Juárez de MéxicoMexico CityMexico
  2. 2.Research UnitHospital Juárez de MéxicoMexico CityMexico
  3. 3.Department of RheumatologyHospital Manuel Gea GonzálezMexico CityMexico
  4. 4.Hospital de Traumatología y OrtopediaUMAE ‘Magdalena de las Salinas’ IMSSMexico CityMexico

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