Successful treatment of rheumatoid arthritis is associated with a reduction in serum sE-selectin and thrombomodulin level.
The aim of this study was to investigate the changes in serum levels of endothelial cell injury markers, soluble (s) E-selectin and thrombomodulin (TM), in patients with rheumatoid arthritis (RA) before and after antirheumatic drug treatment and to assess the relationship between these changes and clinical responses to the drug treatment. Eleven patients with RA having active arthritis and 12 healthy volunteers were enrolled in the study. They were monitored by clinical and laboratory parameters while receiving a combination of methotrexate, hydroxychloroquine and sulphasalazine. Pre- and post-treatment clinical and laboratory parameters, including sE-selectin and sTM levels, were measured. The ages of the patients were comparable with those of the control groups. Significant improvements were detected in erythrocyte sedimentation rate, C-reactive protein, hemoglobin, morning stiffness, patients' global assessment, physicians' global assessment, number of tender joints and number of swollen joints improved at the end of the therapy (for each parameter p < 0.05). Significant improvements were detected in clinical and laboratory parameters. In the patient group there were significant decreases in the levels of sTM and sE-selectin after treatment (p < 0.05). The patient group had significantly higher sTM and sE-selectin levels than the control group at the beginning of the study (p < 0.01), but the difference returned to normal after the treatment (p > 0.05). The sE-selectin and sTM levels significantly correlated with each other, and also with clinical and laboratory findings. Combination treatment successfully treated RA patients. sE-selectin and sTM levels probably reflect disease activity and can be helpful in monitoring disease status and response to therapy.
Department of Rheumatology, Pamukkale University, Medical School, Bursa Caddesi No: 119 Kinikli, Denizli, Turkey. vcobankara@hotmail.com
Veli
V
Cobankara
Düzgün
D
Ozatli
Sedat
S
Kiraz
Mehmet Akif
MA
Oztürk
Ihsan
I
Ertenli
Tufan
T
Türk
Sule
S
Apras
Ibrahim C
IC
Haznedaroglu
Meral
M
Calgüneri
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D004359:Drug Therapy, Combination; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006304:Health Status; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000627:therapeutic use; D018180:Thrombomodulin / Q000097:blood*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D015415:Biomarkers; D019040:E-Selectin; D018180:Thrombomodulin; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D008727:Methotrexate