Circulating soluble E-selectin in early rheumatoid arthritis: a prospective five year study

• Published in: Annals of the rheumatic diseases Vol. 61; no. 3; pp. 242 - 246
• Main Authors: Kuuliala, A, Eberhardt, K, Takala, A, Kautiainen, H, Repo, H, Leirisalo-Repo, M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.03.2002; BMJ; BMJ Publishing Group Ltd; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; area under the curve; Arthritis, Rheumatoid - blood; AUC; Biological and medical sciences; Biomarkers - blood; Blood; Blood Sedimentation; C reactive protein; C-Reactive Protein - analysis; Cell adhesion & migration; Cell adhesion molecules; Chronic illnesses; Clinical Medicine; Comorbidity; confidence interval; CRP; disease modifying antirheumatic drugs; Diseases of the osteoarticular system; DMARDs; E-selectin; E-Selectin - blood; Endothelium; Enzyme-Linked Immunosorbent Assay; erythrocyte sedimentation rate; ESR; Extended Report; Family medical history; Female; HAQ; Health aspects; Health Assessment Questionnaire; Health Status; Humans; Inflammation; Inflammatory joint diseases; interquartile range; IQR; Klinisk medicin; Laboratories; Leukocyte Count; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Mortality; Neutrophils; odds ratio; Physiological aspects; Prospective Studies; Rheumatoid arthritis; Statistics as Topic; WBC; white blood cell count; Human; Immunopathology; Prognosis; Immune response; Pathogenesis; E Selectin; Diseases of the osteoarticular system; Evolutivity; Autoimmune disease; Inflammatory joint disease; Activation; Inflammation; Soluble form; Epidemiology; Endothelium; Chronic; Correlation analysis; Follow up study; Rheumatoid arthritis; Serum; ELISA assay; Public health
• ISSN: 0003-4967; 1468-2060; 1468-2060
• DOI: 10.1136/ard.61.3.242

Background: Soluble E-selectin (sE-selectin) is a marker of activation of vascular endothelium. Objective: To examine serum levels of sE-selectin in a cohort of 85 patients with early rheumatoid arthritis (RA) followed up for five years. Methods: sE-selectin levels were assessed annually using an enzyme linked immunosorbent assay (ELISA) and related to simultaneously obtained clinical and laboratory measures. Joint inflammation was evaluated by active joint count, functional status by Health Assessment Questionnaire (HAQ), and radiographic findings in hands and feet by the Larsen method. Laboratory tests included serum C reactive protein (CRP) level, erythrocyte sedimentation rate, blood haemoglobin level, white blood cell count (WBC), and platelet count. Area under the curve (AUC) was calculated for each variable, and Jonckheere's test for ordered alternatives was applied to assess significance of association between sE-selectin AUC tertiles and other variables. Baseline sE-selectin tertiles were related to change in Larsen score and HAQ score at five years. Odds ratios (OR) with 95% confidence interval (CI) were calculated using univariate and multivariate logistic regression. Results: sE-selectin levels were associated with CRP level (p=0.012), WBC (p=0.037), active joint count (p=0.019), progression of joint destruction (p=0.038), and HAQ score at five years (p=0.021), but not with extra-articular symptoms or comorbidity. Baseline sE-selectin levels in the third tertile predicted the HAQ score at five years (OR 4.18, 95% CI 1.15 to 15.22). sE-selectin levels of patients did not differ significantly from those of healthy control subjects. Conclusion: The degree of activation of vascular endothelium is associated with activity and outcome of early RA.