AB0108 Relationship between progranulin and musculoskeletal ultrasound in rheumatoid arthritis
Authors: A.A. Negm, M.H. Nassr, H.M. Fathi, N.A. Fouad, O. Zaki, S.H. Senara
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Progranulin (PGRN) is a pluripotent, secretory growth factor, mainly present in cells of the epithelium, central nervous system and immune system. PGRN known to directly regulate regulatory T cells and recently found to be upregulated in Rheumatoid Arthritis (RA) and related to its activity. No attempts was made to explore the relation between PGRN and RA activity measured by clinical and Ultrasound score (USS). <h3>Objectives</h3> To explore PGRN levels in the serum of patients with RA, and its correlation with disease activity assessed clinically combined by ultrasonography (USS). <h3>Methods</h3> RA patients: 52 RA patients were included in this study. They were consecutively recruited from the outpatient clinic of Rheumatology Department for regular follow-up at Fayoum University Hospitals. Patients were classified according to the 2010 ACR/EULAR criteria. Control group: 20 age and sex matched healthy volunteers were recruited as controls for level of serum PGRN. Informed consent was obtained from all patients and controls for inclusion in the study. All patients were subjected to full history taking, and clinical examination. Assessment of disease activity by modified DAS-28 score. Progranulin is measured by an ELISA Kit (Elabscience), this kit uses sandwich-ELISA as the method. The ultrasound examination was performed with GE LOGIQ 7 PRO equipment using a linear transducer with 18 MHz frequency. The patients were examined according to the German US7 score in 7 joint areas. <h3>Results</h3> <b>Demographic and clinical data of the RA group:</b> Females represents 90.4% (47 of 52). Age ranged from 21–72 years, mean age was 42.8±10.4 years. Disease duration ranged from 1 to 30 years, median 4 years. Their mean ESR level was 36.4±16 (Range: 5–70). The median of Ultrasound score assessment was 8 while the mean was 8.73±6.9 (Range: 0–33). <b>Serum PGRN concentrations in RA patients and healthy controls:</b> The median of serum PRGN levels in RA patients was 65 ng/ml (mean, 92.54±45.4) which is much higher in comparison to those in normal controls, median 31 ng/ml (mean, 32.74±9.2); the difference showed high statistical significance, p&lt;0.001. <h3>Correlation analysis</h3> The relationships between PRGN levels and other continuous variables were analysed using Spearman's rank correlation. There was high statistically significant correlation between PRGN level and USS score (r=0.37, p=0.006). Also, there was high statistically significant correlation between PRGN level and ESR (r=0.67, p&lt;0.000) and between PRGN level and DAS 28 (r=0.74, p&lt;0.000). There was high statistically significant correlation between USS score and ESR level (r=0.54, p&lt;0.000) and between USS score and DAS 28 (r=0.68, p&lt;0.000). <h3>Conclusions</h3> The serum Progranulin levels were higher in the serum of RA patients than age and sex matched controls. It is positively correlated with diseases activity measured by DAS 28, ESR and Ultrasound activity measured by German US7 score. Serum PGRN levels may be a useful biomarker in RA disease. Ultrasound positively correlated with ESR and DAS 28 in our cohort of RA patients. <h3>Reference</h3> [1] Chen J, Li S, Shi J, Zhang L, et al. Serum progranulin irrelated with Breg cell levels, but elevated in RA patients, reflecting high disease activity. Rheumatology international2016Mar 1;36(3):359–64. <h3>Disclosure of Interest</h3> None declared