AIMS OF THE STUDY: To assess and compare resistin levels in the serum and synovial fluid of patients with rheumatoid arthritis (RA; an inflammatory rheumatologic disease) and osteoarthritis (OA; a degenerative rheumatologic disease) and to study the relationship between resistin levels and prognostic factors of RA disease progression.

PATIENTS AND METHODS: This study included a total of 50 patients: 25 with RA and 25 with OA. Full case history was documented for all patients and all underwent a thorough clinical examination and laboratory testing. Body mass index (BMI) values were also calculated. Radiographs were made of OA patients' knees and RA patients' hands. Disease Activity Score 28 (DAS28) was calculated for RA patients. Serum and synovial fluid samples were obtained from the effused knees of all patients and tested for resistin level.

RESULTS: Serum resistin levels were higher in RA patients than in those with OA (p < 0.01). Synovial fluid resistin levels were also higher in RA than OA patients (p < 0.001). While serum resistin levels correlated with Larsen score and total leukocyte count (TLC), synovial fluid resistin levels correlated with rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) levels in addition to Larsen score and TLC.

CONCLUSION: Resistin levels were found to be higher in the serum and synovial fluid of RA patients than in those with OA. This may suggest a role for resistin in inflammatory rheumatologic diseases. The observed statistically significant correlation between synovial fluid resistin levels and RF, ACPA and Larsen score may suggest that high synovial fluid resistin levels can be considered a poor prognostic factor for RA progression. However, further studies employing a larger cohort of patients are needed to confirm the relevance of resistin as a prognostic marker in RA patients.

BACKGROUND: Few studies have reported a possible involvement of pleiotrophin (PTN) in the pathophysiology of osteoarthritis (OA) and very little is known about its role in rheumatoid arthritis (RA). This study is to measure PTN in the sera and synovial fluids in RA and OA and to assess its relation to activity, functional class and radiological staging.

SUBJECTS AND METHODS: Serum and synovial fluid samples were collected from 35 RA patients and 40 knee OA patients and serum samples were withdrawn from 20 healthy controls. Demographic, clinical and serological data were prospectively assessed. Functional and radiographic grades were also assessed. Serum and synovial fluid PTN levels were measured using enzyme-linked immunosorbent assay (ELISA).

RESULTS: There was no statistical significant differences (p > 0.05) on comparing the mean PTN level in sera of RA, OA patients and healthy controls. However the mean synovial fluid level of PTN in both patient groups was significantly higher than mean serum level (p < 0.001). Significant correlations between the serum PTN level and both morning stiffness duration (p = 0.008) and mHAQ score (p = 0.039) were only observed in RA patients.

CONCLUSION: Our results point to a possible important role of PTN in RA and OA. We firstly report a serological pattern of PTN in the sera and synovial fluids of RA patients. However its implementation as a disease marker or a potential target therapy in both diseases awaits larger studies and further investigations.

To detect the incidence of premature atherosclerosis in systemic lupus erythematosus (SLE) patients and to study its association with disease activity and damage indices.
PATIENTS AND METHODS:
This study involved 50 adult female SLE patients with mean age 26.24 ± 8.63 years and mean disease duration 3.44 ± 4.01 years. The control group comprised 25 healthy adult females. All patients were subjected to a detailed clinical examination and laboratory investigations, and full case history was recorded. Assessment of disease activity was performed according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease damage was assessed using the Systemic Lupus International Collaborating Clinics (SLICC) score. B mode ultrasound was used to measure the intima-media wall thickness (IMT) and detect the presence of carotid plaques.
RESULTS:
In 15 patients (30 %), positive ultrasonographic findings represented by a significant increase in IMT (> 0.9 mm) could be shown; plaques were found in 3 of these patients (6 %). A significant difference was found between SLE patients and controls in terms of IMT (P < 0.0001). On subgrouping the SLE patients according to their IMT, there was a significant difference between those with thickened and normal IMT in terms of SLEDAI (P < 0.0001) and SLICC (p = 0.035) scores.
CONCLUSION:
Subclinical atherosclerosis is frequent in SLE patients. Increased disease activity and damage are associated with the occurrence of premature atherosclerosis.