AB0053 A Useful Marker in Assessment of Remission and Activation of Disease in Patients with Rheumatoid Arthritis: Serum Human Neutrophil Peptides 1-3
Authors: M. Okcu, P. Oktayoglu, N. Mete, M. Bozkurt, M. Caglayan, K. Nas
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic disease of unknown etiology that is characterized by articular inflammation and deformities and may also present with extra-articular findings. Various cellular and molecular immunological factors are involved in the pathophysiology of RA. Recent studies suggest that neutrophils and alpha-defensins released from the neutrophils assume significant roles in the pathogenesis of RA. <h3>Objectives</h3> The purpose of this study was to investigate the potential association between serum alpha-defensin levels especially human neutrophil peptides (HNP) 1–3 and disease activity, functional status and radiologic damage as well as some other laboratory parameters such as erythrocyte sedimentation rate (ESH) and C-reactive protein (CRP) in patients with RA. <h3>Methods</h3> A total of 42 patients with established RA who presented to the Outpatient Clinic of Physical Medicine and Rehabilitation of Dicle University Hospital and 38 healthy control subjects were included in this study. All the subjects underwent a through physical examination. Swollen and tender joints were noted for each patient. Disease activity was assessed by Disease Activity Scale 28 (DAS28). Quality of life was assessed by Rheumatoid Arthritis Quality of Life (RAQoL) Questionnaire and Nottingham Health Profile (NHP). Functional status was assessed by Stanford Health Assessment Questionnaire (HAQ). Laboratory examinations included complete blood count, ESH, CRP, and human neutrophil peptides (HNP) 1–3 tests. <h3>Results</h3> The patients with an active disease exhibited higher HNP 1–3 levels compared to the patients in remission. At cut off 708 pg/ml, the sensitivity and the specificity of the test for HNP 1–3 were 72% and 70.6%, respectively. Moreover, HNP 1–3 levels correlated significantly with WBC counts as well as with HAQ, NHP total, NHP pain, NHP physical activity and NHP sleep scores. There were no significant differences between the patients and the control subjects in serum HNP 1–3 levels. <h3>Conclusions</h3> In the present study, serum HNP 1–3 levels correlated significantly with WBC counts as well as with HAQ, NHP total, NHP pain, NHP physical activity, and NHP sleep scores. In addition, the patients with an active disease had significantly higher serum HNP 1–3 levels compared to the patients in remission. In this respect, serum HNP 1–3 can be a useful marker in assessment of disease activity and remission in patients with RA. <h3>References</h3> Bokarewa MI et al. Intraarticular release and accumulation of defensins and bactericidal/permeability-increasing protein in patients with RA. J Rheumatol 2003, 30:1719–24. Arnett FC et al. ACR 1987 revised criteria for classification of RA. Arthritis Rheum, 1988;31:315–24. Fransen J et al. RA Measures: Disease Activity Score, Disease Activity Score-28, Rapid Assessment of Disease Activity in Rheumatology and RA Disease Activity Index. Arthritis Rheum 2003;49:214–24. De Jong Z et al. Reliability and construct validity of the RAQoL: a rheumatoid arthritis-specific quality of life instrument. Br J Rheumatol 1997;36:878–83. Hunt SM, et al. The NHP: subjective health status and medical consultations. Soc Sci Med. 1981;15:221–9 Bruce B, et al. The Stanford health assessment questionnaire: dimensions and practical applications. Health Qual Life Outcomes 2003;1, 20. <h3>Disclosure of Interest</h3> None declared