AB0228 Immunological approach to the diagnosis of lesions of the nervous system in patients with rheumatoid arthritis
Authors: IP Gontar, EV Baranov, LA Maslakova, AS Trofimenko, OV Paramonova
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Although S100 proteins represent 40% of the neutrophil cytoplasmic proteins, their physiological and pathological functions are still unclear. S100 protein concentrations are dramatically enhanced in synovial fluid and synovium of patients suffering from rheumatoid arthritis (RA). Their expression seems to correlate with disease activity and joint damage [1]. <h3>Objectives</h3> Improvement of immunological detection of neurological involvement in RA by means of polyacrylamide magnetic beads with immobilized S- 100 protein. <h3>Methods</h3> The research was carried out in agreement with the principles of the World Medical Association Declaration of Helsinki. The informed consent had been signed by all involved persons, another obligate requirement was age 18 years or more. The patients were from the rheumatologic wards in Volgograd Municipal Hospital No. 25 and Volzhsky Municipal Hospital No. 1. Diagnosis of RA was established by ACR-EULAR criteria (2010), RA activity was evaluated using DAS28. Serum anti-S-100 protein antibodies were measured by ELISA, with S-100 protein immobilized on polyacrylamide magnetic beads as an antigen. The antibody concentrations were expressed as optical density units (ODU) and were considered positive if the cutoff value (M+2σ of the reference group, 0.050 ODU) was exceeded. The results were expressed as mean±σ, differences were considered significant when p&lt;0.05. Pearson correlation coefficient (r) was also used. <h3>Results</h3> 40 healthy persons (29 mans and 11 women), and 95 female patients with RA and the neurological signs, appeared during active phase of the disease, were recruited for this study. Mean age of the healthy controls was 36±7 years, and for the RA group it was equal to 55±11 years. Mean RA duration was 4.2±2.9 years. 13 patients had low, 52 – moderate, and 8 – high disease activity. The most common types of neurological involvement were mononeuropathy (n=29), polyneuropathy (n=65), radiculopathy (n=80); cervicocranialgias (n=51), and trigeminal neuralgias (n=14). The symptoms of central nervous system damage (TIA, seizures, cerebellar ataxia, dysarthria) were found in 21 patients. In RA group, anti-S-100 protein antibodies were detected in 11 (32.4%) cases, with mean concentration 0.078±0.028 ODU. The patients with different neurological signs had mean anti-S-100 protein antibody concentration 0.138±0.046 ODU, the subgroup without any neurological signs had 0.060±0.024 ODU (p=0.022). In all cases analyzed index correlated with the degree of activity of the pathological process. High levels of antibodies to S-100 protein in RA associated with central nervous system (CNS) and peripheral nervous system (PNS). <h3>Conclusions</h3> We found an association between neurological involvement in RA and elevation of anti-S-100 protein antibody concentrations. These findings give us an opportunity to improve the diagnosis of minor neurological damage in RA and thus to make more precise adjustment of the treatment. <h3>References</h3> Baillet A. S100A8, S100A9 and S100A12 proteins in rheumatoid arthritis. Rev Med Interne. 2010 Jun;31(6):458–61. <h3>Disclosure of Interest</h3> None declared