BackgroundPyridinoline (Pyd) is a 3-hydroxypyridinium derivative which is an intermolecular cross-link compound of type I and II collagen.1 It is a marker of bone resorption based on bone biopsy and radioisotope kinetics studies.2In rheumatoid arthritis (RA), destruction of bones may contribute to increased levels of serum Pyd.ObjectivesThe purpose of this study was to compare the serum pyridinoline (Pyd) levels between RA patients and healthy controls and to determine the correlation of serum Pyd levels with radiographic joint erosions.MethodsThis was a monocentric, cross sectional, case-control study which was conducted from June 2016 to February 2017 at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Serum samples were obtained from 48 patients with RA and 48 healthy controls. The enzyme-linked immunosorbent assay (ELISA) method was used for quantitative analysis of serum Pyd. Besides, all the RA patients were assessed for joint damage based on Modified Sharp Score (MSS), disease activity based on the disease activity score in 28-joints (DAS 28) and functional capacity based on Health Assessment Questionnaires Disability Index (HAQ-DI).Abstract AB0301 – Table 1Correlation between serum pyridinoline and other clinical variablesResultsThe median serum Pyd levels was much higher among the RA patients (110.20 ng/mL [92.30–120.64]) compared to the controls (98.22 ng/mL [85.54–111.41]); p<0.05. RA patients with erosive disease had significantly higher serum Pyd levels (p=0.024). There was a significant positive correlation between serum Pyd levels and joint erosion score (r=0.285, p=0.049). The serum Pyd levels had no demonstrable association with disease activity or functional capacity. Neither steroid nor biologic therapy influenced the levels of serum Pyd.ConclusionsRA patients had significantly higher levels of serum Pyd compared to healthy controls. The serum Pyd levels had significant correlation with radiographic joint erosions which reflected disease damage.References[1] Nemoto R, Nakamura I, Nishijima Y, Shiobara K, Shimizu M, Takehara T, et al. Serum pyridinoline crosslinks as markers of tumour-induced bone resorption. Br J Urol. 1997;80:274–80.[2] Plant MJ, Williams AL, O’Sullivan MM, Lewis PA, Coles EC, Jessop JD. Relationship between time-integrated C-reactive protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum2000;43:1473–7.AcknowledgementsThe authors would like to thank the Research Committee of UKMMC for funding this research.Disclosure of InterestNone declared
BackgroundSystemic Lupus erythematous (SLE) is an autoimmune disease with a wide spectrum of clinical manifestations and characterized by remission and flares. Recent epidemiological studies postulated that air pollution confers an increased risk of flare in various autoimmune diseases. Haze is a common phenomenon afflicting Southeast Asia (SEA), including Malaysia, and has occurred almost every year within the last few decades.ObjectivesThis study was aimed to determine the correlation and association between SLE disease activity with exposure to inhaled Particulate Matter (PM10) and Nitrogen Dioxide (NO2).MethodsSLE patients who attended rheumatology and nephrology clinic in University Kebangsaan Malaysia Medical Centre (UKMMC) from June 2019 until March 2020 were recruited. Their medical records were reviewed for retrospective assessments of the disease activity using the Modified-SLE Disease Activity Index (M-SLEDAI) and The British Isles Lupus Assessment Group (BILAG 2004) index from January 2015 until September 2019. Clinic visits with presence of infection or recent change of immunosuppressive treatment of ≤ 3 months were excluded. The average of daily concentrations of inhaled PM10 (µg/m3), and NO2 (ppb) were evaluated within 30 days preceding the clinic visits, and the data was obtained from Department of Environment (DOE) Malaysia. Comparison of the means was performed by Student’s t-test; and the correlations between PM10, and NO2 were determined by Pearson’s correlation coefficient. The associations between the effect of daily pollutant concentrations on M-SLEDAI and BILAG 2004 scores were analyzed using the generalized estimating equation (GEE) model, while considering fixed effects for repeated measures.ResultsA total of 46 patients were recruited with 603 clinic visits were recorded. A significantly higher NO2 level was found in active disease patients with M-SLEDAI score of ≥ 4 (33.09 ± 9.15 vs 31.09 ± 9.79, p=0.32), and presence of BILAG B and/or A (score ≥ 8), 35.03± 2.97 vs 31.1 ± 9.8, p= 0.003). There were positive correlations between M-SLEDAI scores (rs 0.128, p=0.002) and BILAG scores with NO2, (rs 0.142, p<0.001). In the GEE analysis, significant correlations were found between M-SLEDAI score [OR 1.27 (95% C.I: 1.06-1.53), p=0.01] and BILAG score with NO2 [OR 1.47 (95% C.I: 1.15-2.1.88), p=0.002].ConclusionOur study suggests that air pollutant NO2 exposure 30 days prior to clinic visit is associated with high disease activity among patients with SLE in Malaysia. Further prospective study is warranted to confirm this finding.References[1]Fernandes EC, et al. Exposure to Air Pollutants and Disease Activity in Juvenile-Onset Systemic Lupus Erythematosus Patients. Arthritis Care Res (Hoboken). 2015 Nov;67(11):1609-14.AcknowledgementsDepartment of Environment (DOE), Ministry of Environment And Water, MalaysiaDisclosure of InterestsNone declared
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