Serum substance P: an indicator of disease activity and subclinical inflammation in rheumatoid arthritis

Abstract

The aim of the is study is to examine the role of serum substance P (SP) levels as a simple biomarker for rheumatoid arthritis (RA) disease activity, its correlation with other markers of disease activity, and with selected clinical parameters. The study comprised 90 RA patients and 24 healthy controls. RA activity was assessed by means of the disease activity 28-C-reactive protein (DAS28-CRP) index and ultrasound power Doppler (USPD) by the German ultrasound score based on seven joints. SP serum values were obtained by means of an ELISA commercial kit. Statistics were achieved by the Student's t test and Spearman correlation analysis with Bonferroni correction. As a group, RA patients had significantly increased levels of SP compared with healthy controls (p < 0.0001). SP levels correlated with DAS28-CRP (r = 0.5050, p < 0.0001), number of tender joints (NTJ, r = 0.4668, p < 0.0001), number of swollen joints (NSJ, r = 0.4439, p < 0.0001), visual analogue scale (VAS, r = 0.5131, p < 0.0001). However, SP did not correlate with CRP levels (r = 0.0468, p = 0.6613), nor with the USPD (r = 0.1740, p = 0.1009). Elevated serum SP is a common feature of RA patients, which also appears to correlate with clinical measurements of disease activity and with subjective clinical data (NTJ and VAS). Thus, although SP is higher in RA patients with high disease activity, it also detects subtle RA disease activity even in patients in apparent remission, which suggests its usefulness for therapeutic decisions.

Dynamics of C-reactive protein in conditions of substance P block

“…Trends are defined comparing the previous series of duration of inflammation in relation to concentration of C-reactive proteinbetween 6 hours and 1 day (p=0.08), between 1 and 2 days (p=0.08), between 2 and 3 days (p=0.08), between 3 and 5 days (p=0.05), between 7 and 10 days (p=0.08). The revealed trends in the dynamics of CRP blood concentration separately correlate with the scattered in multiple studies of other authors [3,5,[11][12][13][14][21][22][23]. Thus, it is reasonable that substance P depression is associated with less expressive dynamics of CRP blood concentration because as soon as substance P has shown the involvement in the process of an inflammation upregulation [5,21].…”

“…In inflammation an integral role is played by substance P [1][2][3][4][5]. It is involved in an initiation of T-helpers type 2 migration, associated with intensity of inflammation [6].…”

The Neurochemical Characterization of Parasympathetic Nerve Fibers in the Porcine Uterine Wall Under Physiological Conditions and After Exposure to Bisphenol A (BPA)

“…So changes in the expression of neuronal factors may result from inflammatory processes. Admittedly, during the experiment, the symptoms of inflammation were not observed, but fluctuations in neuromediators and/or neuromodulators may be the first subclinical signs of pathological processes (Barbosa-Cobos et al 2018 ), and such a situation may have taken place in the case of the present study.…”

Substance P, A Promising Therapeutic Target in Musculoskeletal Disorders

“…The NK1R antagonist, a promising agent for RA patients, should be studied to verify its effectiveness. In addition to its potential as a therapeutic target, the serum SP level was reported as an indicator of disease activity and subclinical inflammation in patients with RA [ 77 ].…”