Cellular and humoral markers of systemic inflammation in acute reactive arthritis and early rheumatoid arthritis.
OBJECTIVE
To compare systemic inflammation in reactive arthritis (ReA), rheumatoid arthritis (RA), and sepsis using novel markers of systemic inflammation, and to study whether they are helpful in distinguishing between ReA and RA.


METHODS
In 28 patients with acute ReA, 16 patients with early untreated RA, and 25 patients with blood culture-positive sepsis, phagocyte CD 11b expression was measured by flow cytometry, serum procalcitonin (PCT) levels by immunoluminometric assay, and soluble E-selectin (sE-selectin) levels by enzyme-linked immunosorbent assay (ELISA).


RESULTS
Neutrophil and monocyte CD11b expression and serum levels of PCT and sE-selectin were higher in patients with sepsis than patients with ReA or RA, or in healthy subjects (all p < 0.01). They were comparable in healthy subjects, ReA, and RA.


CONCLUSIONS
Patients with acute ReA and early RA have normal CD11b expression levels on phagocytes and normal PCT and sE-selectin levels in serum. Elevated levels suggest possible sepsis.
Kuuliala
A
A
Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Finland. antti.kuuliala@helsinki.fi
Takala
A
A
Siitonen
S
S
Leirisalo-Repo
M
M
Repo
H
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016918:Arthritis, Reactive / Q000097:blood / Q000175:diagnosis*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis*; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D018845:CD11 Antigens / Q000032:analysis; D015331:Cohort Studies; D019040:E-Selectin / Q000032:analysis; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis; D018836:Inflammation Mediators / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D000091402:Prohibitins; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D015415:Biomarkers; D018845:CD11 Antigens; D019040:E-Selectin; D018836:Inflammation Mediators; C000717331:PHB2 protein, human; D000091402:Prohibitins; D002097:C-Reactive Protein