title: Serum levels of asymmetric dimethylarginine and apelin as potential markers of vascular endothelial dysfunction in early rheumatoid arthritis.
abstract: OBJECTIVE
  Impaired endothelial function represents the early stage of atherosclerosis, which is typically associated with systemic inflammatory diseases like rheumatoid arthritis (RA). As modulators of endothelial nitric oxide synthase expression, asymmetric-dimethylarginine (ADMA) and apelin might be measured in the blood of RA patients to detect early atherosclerotic changes. We conducted a prospective, case-control study to investigate serum ADMA and apelin profiles of patients with early-stage RA (ERA) before and after disease-modifying antirheumatic drug (DMARD) therapy.
  
  
  METHODS
  We enrolled 20 consecutively diagnosed, treatment-naïve patients with ERA and 20 matched healthy controls. Serum ADMA and apelin levels and the 28-joint disease activity scores (DAS28) were assessed before and after 12 months of DMARDs treatment. All patients underwent ultrasonographic assessment for intima-media tickness (IMT) evaluation.
  
  
  RESULTS
  In the ERA group, ADMA serum levels were significantly higher than controls at baseline (P = 0.007) and significantly decreased after treatment (P = 0.012 versus controls). Baseline serum apelin levels were significantly decreased in this group (P = 0.0001 versus controls), but they were not significantly altered by treatment. IMT did not show significant changes.
  
  
  CONCLUSIONS
  ERA is associated with alterations of serum ADMA and apelin levels, which might be used as biomarkers to detect early endothelial dysfunction in these patients.
authors.affiliation: Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Viale Del Policlinico 155, 00161 Rome, Italy. manuela.difranco@uniroma1.it
authors.forename: Manuela
authors.initials: M
authors.lastname: Di Franco
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Spinelli
authors.forename: Alessio
authors.initials: A
authors.lastname: Metere
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Gerardi
authors.forename: Virginia
authors.initials: V
authors.lastname: Conti
authors.forename: Francesca
authors.initials: F
authors.lastname: Boccalini
authors.forename: Cristina
authors.initials: C
authors.lastname: Iannuccelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciciarello
authors.forename: Luciano
authors.initials: L
authors.lastname: Agati
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D000073861:Apelin; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: C115436:APLN protein, human; D018501:Antirheumatic Agents; D000073861:Apelin; D036341:Intercellular Signaling Peptides and Proteins; C018524:N,N-dimethylarginine; D001120:Arginine