Abstract
The purpose of the present study was to investigate the value
of different markers of collagen metabolism in assessing the disease
process and further disease progression in patients with inflammatory
arthritis, mainly rheumatoid arthritis (RA).
In a series of 59 patients with RA and knee joint effusion,
the level of synovial fluid (SF) carboxyterminal telopeptide of
type I collagen (ICTP), a marker for type I collagen degradation,
was associated with the Larsen's grade of the corresponding
joint (p < 0.001). The mean SF concentrations of ICTP
and the markers of type I and III collagen synthesis (the aminoterminal
propeptides of type I and III procollagens, PINP and PIIINP) were
higher than those in serum. In addition, the levels of these markers
correlated with each other in both serum and SF (p < 0.001
in both occasions).
In a three-year follow-up study of 44 RA patients from the
abovementioned series and 11 patients with other chronic arthritides,
a high SF ICTP level turned out to reflect accelerated radiological
progression in the assessed joint (p < 0.05). Contrary
to this, the results on the SF leukocyte level were contradictory.
In a population-based cross-sectional series of 90 patients
with advanced RA, elevated baseline serum ICTP levels discriminated
the patients with a need for total joint replacement surgery from
those with milder disease (p = 0.001) in a three-year
follow-up.In a study of 52 patients with recent onset RA, the changes
in BMD during a two-year follow-up were not associated with the
serum level of markers of type I collagen metabolism. In this series,
however, the decrease in BMD (measured in the spine and the femoral
neck) was smaller than earlier reported.
In a three-year follow-up series of 63 patients with early
RA, the patients with simultaneously elevated serum ICTP (> 4.6
mg/l) and RF positivity at baseline, had an increased
risk for progressive joint disease (an increase in Larsen's
score > 20 as assessed from radiographs of hands and feet)
with an odds ratio of 9.1 (95% CI 2.5 to 32.9). A risk
profile of this kind may be useful in early disease assessment
to identify the patients who will need the most active drug therapy.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-5311-6 |
| Date | 22 June 1999 |
| Creators | Åman, S. (Sari) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 1999 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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