Human glycoprotein of cartilage (YKL-40) synthesizes chondrocytes and synovial cells in inflammatory conditions or remodels the outer cell matrix in osteoarthritis. The aim of this study was to conduct a parallel analysis between thickness of cartilage and length of osteophytes, ultrasound indicators of joint destruction, with levels of YKL-40 in serum in patients with primary osteoarthritis. Ultrasound findings and concentration of YKL-40(ng/ml) were examined in 88 patients. The average value cartilage thickness measured on medial condyles of the femur was 1.30 +/- 0.23 mm and on lateral was 1.39 +/- 0.27 mm. Median YKL-40 in patients with shorter osteophytes was 62.0 (44.5-90) ng/ml, and with longer osteophytes was 119 (range 80-171) ng/ml (p = 0.000). YKL-40 can be a marker for the appearance of longer osteophytes (sensitivity = 79.1%; specificity = 61.9%; cut off = 75.0 ng/ml). The duration of illness is very much connected to values of YKL-40 (r = 0.651, p = 0.000). After an illness duration of five years, the concentration of YKL-40 was 83.68 +/- 33.65 ng/ml, after ten years it was 138.22 +/- 48.88 ng/ml, and after 15 and 20 years it was 209.30 +/- 79.36 ng/ml and 218.50 +/- 106.51 ng/ml, respectively. Higher concentrations of YKL-40 indicate the level of cartilage destruction and can be used for assessment of destruction.
Chondrocytes and synovial cells synthesize Cartilage Oligomeric Matrix Protein (COMP) when activated by proinflammatory cytokines. The aim of this study was to analyze and compare ultrasound parameters of joint inflammation, effusion and synovitis with the levels of COMP in the serum of patients with primary osteoarthritis. Ultrasound was done and the concentration of COMP (ng/mL was examined in 88 patients. 75% of patients had effusion (size 10.13±4.35 mm), 62.5% had effusion in lateral recessus (LR), 28.4% (size 8.53±2.27 mm) in suprapatelar (SR), and 27.3% (size 11.38±4.44 mm) in medial (MR). 67% of patients had synovitis size 4.84±3.57 mm in SR, 3.15±1.86 mm in MR; and 6.09±2.80 mm in LR. 17.0% of patients had nodular type of synovitis, 30.7% had diffusive, and 19.3% nodular - diffusive. There was a significant link between the size of synovitis and effusion in SR (r = 0.966, p = 0.000), MR (r = 0.812, p = 0.009) and LR (r = 0.886, p = 0.003). The median of COMP concentration was 54 (44.5-58) ng/mL in patients without effusion. In those with effusion it was 57 (48.75-64.25) ng/mL (p = 0.030). Without synovitis it was 52 (45.5-58) ng/mL, with synovitis 58 (50-66) ng/mL, (p = 0.006), diffusion type synovitis 60 (50-67) ng/mL, nodular 57 (50-62) ng/mL, nodular-diffusion 54 (44.5-66.5) ng/mL (p = 0.014). With longer osteophytes the median of COMP was 56 (48-64) ng/mL, with shorter osteophytes 55 (46.5-59) ng/mL (p = 0.000). Cartilage oligomeric matrix protein has a moderate significance in the assessment of disturbance of the metabolism of synovial and cartilage tissue in patients with knee osteoarthritis (sensitivity = 59%; specificity = 50%; cut off = 53.5 ng/mL).
Immune Complexes and Complement in Serum and Synovial Fluid of Rheumatoid Arthritis PatientsRheumatoid arthritis (RA) is predominantly an intraarticular inflammatory and autoimmune disease that involves different autoantibodies and effector mechanisms. The aim of the study was to determine the utility of Circulating Immune Complexes (CIC) and complement components (C3c, C4) as possible markers for the disease activity in laboratory diagnostics. In a cross-section study 59 patients, according to the clinical criteria, were categorized into two groups: group with moderate (MA, n=24), and group with severe activity (SA, n=35) of RA. The concentration of CIC, C3c and C4 in sera (S) and synovial fluids (SF) was examined by an immunonephelometric method in both groups and compared with values in the control group (n=15) of patients with lesions of the menisci. Obtained results showed that there was no statistical significance in the values of C3c and C4, in both biological fluids, among all tested groups. Significant differences were found in the levels of CIC in both fluids, while testing the parameters (× ± SD, IU/mL) in the sera of groups with SA and MA of RA: 7.43 ± 13.40; 3.01 ± 2.92 (p<0.05) and SF: 13.47 ± 21.1, 5.33 ± 7.53 (p<0.001), respectively. These differences were higher between the group with SA and CG. Results for the concentrations of CIC were significantly higher in SF compared to sera: in the RA group with SA by 77% and group with MA by about 82%. These data could provide a confirmation of the hypothesis about local, intraarticular autoantibodies and subsequent CIC production. It can be concluded that the examination of CIC concentration in serum, and where it is possible in SF, is a useful marker of disease activity in RA patients, in contrast to the tested components of the complement. This statement does not exclude their consumption within immune effector mechanisms, but elicits the possibility that lower molecular fragments (C3d, C4d), as well as the novel activation products, could be better disease activity markers in RA patients.
Kratak sadr`aj: Osteoartroza (OA) kolena je dege nera tivna bolest sa inflamatornim epizodama koje artrosonografija objektivno prikazuje. Oligomerni protein matriksa hrska vi ce -COMP je korisan marker za ranu destrukciju hrskavice. Cilj rada je uporedna analiza klini~kog, artrosonografskog pregleda i koncentracije COMP u serumu bolesnika radi detekcije zglobne inflamacije. Analizom je obuhva}eno 88 bolesnika sa OA kolena. Klini~kim pregledom je utvr|en izliv, artrosonografskim veli~ina sinovitisa i efuzije, analizom seruma koncentracija COMP (ng/ml). Minimalan izliv je imalo 34,1% bolesnika, umeren 22,7%, zna~ajan 4,5%. Sen zitivnost klini~ke dijagnoze izliva je 73%, a specifi~nost 73% (p=0,000). Efuziju je imalo 75% bolesnika, u suprapatelarnom recesusu (SR) efuziju je imalo 28,4% bolesnika, medijalnom (MR) 27,3%, lateralnom (LR) 62,5%. U SR efuzija je bila 10,13±4,35 mm, MR 8,53±2,27 mm, LR 11,38±4,44 mm. Sinovitis je na|en kod 67% bolesnika, u SR veli~ine 4,84±3,57 mm, MR 3,15±1,86 mm, LR 6,09±2,80 mm. Srednja vrednost veli~ine efuzije kod bole sni ka sa zna~ajnim izlivom u SR je bila 13,85 (10,36-17,43) mm (p=0,000), MR 4,9 (0-10,22) mm (p=0,008), LR 12,0 (11,34-14,50) mm (p=0,000), sa mo u LR sa umerenim izlivom 6,94 (1,16-8,13) mm i mi nimalnim izlivom 4,9 (0 -7,25) mm. Postoji zna~ajna pove za nost veliine sinovitisa i efuzije u SR, MR i LR (p=0,000). Srednja vrednost koncentracije COMP kod bolesnika bez efuzije je bila 54 (44,5-58) ng/mL, sa efuzijom 57 (48,25) ng/mL (p=0,030). Artrosonografija i odre|ivanje koncentracija COMP predstavljaju senzitivne metode u dijagnostikovanju zglobne efuzije.
It has been supposed that low levels of mannose binding lectin (MBL) may be involved in protection of rheumatoid arthritis associated with agalactosil forms of GOIgG immunoglobilins found in rheumatoid synovial fluid and lead to enhanced complement activation and joint cartilage damages. In order to examine the possible link between MBL and mediated complement activation, its concentration was measured in sera and synovial fluids of 59 patients classified in moderate and severe activity RA groups and compared with the levels in the same biological fluids of the control group with menisci lesions. No patients had undetectable or lowered MBL in both RA groups. Mean values were either normal or elevated depending on the severity of the disease as a response to inflammation. This finding does not exclude a possible role of MBL-GOIgG mediated complement activation, but provides no support to mitigating RA severity.
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