title: Circulating soluble E-selectin in early rheumatoid arthritis: a prospective five year study.
abstract: BACKGROUND
  Soluble E-selectin (sE-selectin) is a marker of activation of vascular endothelium.
  
  
  OBJECTIVE
  To examine serum levels of sE-selectin in a cohort of 85 patients with early rheumatoid arthritis (RA) followed up for five years.
  
  
  METHODS
  sE-selectin levels were assessed annually using an enzyme linked immunosorbent assay (ELISA) and related to simultaneously obtained clinical and laboratory measures. Joint inflammation was evaluated by active joint count, functional status by Health Assessment Questionnaire (HAQ), and radiographic findings in hands and feet by the Larsen method. Laboratory tests included serum C reactive protein (CRP) level, erythrocyte sedimentation rate, blood haemoglobin level, white blood cell count (WBC), and platelet count. Area under the curve (AUC) was calculated for each variable, and Jonckheere's test for ordered alternatives was applied to assess significance of association between sE-selectin AUC tertiles and other variables. Baseline sE-selectin tertiles were related to change in Larsen score and HAQ score at five years. Odds ratios (OR) with 95% confidence interval (CI) were calculated using univariate and multivariate logistic regression.
  
  
  RESULTS
  sE-selectin levels were associated with CRP level (p=0.012), WBC (p=0.037), active joint count (p=0.019), progression of joint destruction (p=0.038), and HAQ score at five years (p=0.021), but not with extra-articular symptoms or comorbidity. Baseline sE-selectin levels in the third tertile predicted the HAQ score at five years (OR 4.18, 95% CI 1.15 to 15.22). sE-selectin levels of patients did not differ significantly from those of healthy control subjects.
  
  
  CONCLUSIONS
  The degree of activation of vascular endothelium is associated with activity and outcome of early RA.
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland. antti.kuuliala@helsinki.fi
authors.forename: A
authors.initials: A
authors.lastname: Kuuliala
authors.forename: K
authors.initials: K
authors.lastname: Eberhardt
authors.forename: A
authors.initials: A
authors.lastname: Takala
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.forename: H
authors.initials: H
authors.lastname: Repo
authors.forename: M
authors.initials: M
authors.lastname: Leirisalo-Repo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D019040:E-Selectin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006304:Health Status; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D002097:C-Reactive Protein