Raised serum alkaline phosphatase in rheumatoid disease. An index of liver dysfunction?

Kendall, M. J.; Cockel, R.; J, Becker; Hawkins, C F

doi:10.1136/ard.29.5.537

Cited by 85 publications

(34 citation statements)

References 11 publications

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“…Another source of rise in ALP is hepatic origin as reported by previous studies. (14) A rise in liver type ALP in these studies have implicated that hepatic dysfunction is not uncommon and the activation of rheumatoid process correlates with rise in ALP in cases of active rheumatoid disease. The hepatic changes may be a response to chronic inflammatory disease.…”

Section: Discussionmentioning

confidence: 90%

“…(6,14,15) These studies suggest an increase in baseline serum ALP. These studies have described that the raised serum ADA originates in liver or bone or both implying that these organs are affected by the disease process in rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 96%

“…The higher ALP levels in patients with rheumatoid arthritis is considered to be produced by the active bone formation that is to say a rise in bone type ALP is not a cause but a result of disease activation. (14) Hepatic involvement in rheumatoid arthritis has been reported and liver is one of the organs affected by rheumatoid arthritis. Another source of rise in ALP is hepatic origin as reported by previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Study of Serum Adenosine Deaminase and Alkaline Phosphatase in Rheumatoid Arthritis

Osmani¹,

Sayeed²,

Ali³

2015

jemds

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Rheumatoid arthritis is a chronic systemic autoimmune disorder causing inflammation of the synovial joints leading to joint destruction as well as a variety of extra articular features. In this present study, serum Adenosine deaminase and Alkaline phosphatase levels were studied in patients of rheumatoid arthritis. Thirty patients in the age group of 30-60 years of both sexes and equal number of age and sex matched healthy controls were included in this study. In rheumatoid arthritis patients, serum Adenosine deaminase levels were high, the mean serum Adenosine deaminase levels were 60 ± 9.55 and in controls the mean Adenosine deaminase levels were 21 ± 3.04. The p value was significant at p < 0.001. We conclude that serum Adenosine deaminase can be used as a marker for cell mediated immunity to monitor disease activity in rheumatoid arthritis. Serum Alkaline phosphatase was found to be raised in rheumatoid arthritis, the mean serum Alkaline phosphatase levels were 291.63 ± 35.84 in patients of rheumatoid arthritis when compared to healthy controls (196.73 ± 32.71).The p value was significant at p<0.001. The present study has focused on investigating the serum total Alkaline phosphatase levels in Rheumatoid Arthritis Patients and The findings have indicated a raised serum Alkaline phosphatase in patients of rheumatoid arthritis when compared to healthy controls thereby suggesting the role of serum Alkaline phosphatase as a marker of disease activity in rheumatoid arthritis. KEYWORDS: Rheumatoid arthritis, cell mediated immunity, Adenosine deaminase (ADA), Alkaline phosphatase (ALP). INTRODUCTION:Rheumatoid arthritis is the most common form of inflammatory arthritis affecting approximately 1-2 % of the world's population. (1) There is continuing interest in the metabolic changes occurring in rheumatoid arthritis. The etiology of rheumatoid arthritis is not known but it is classified as an autoimmune disease. (2) Immunological and inflammatory reactions play an important role in the initiation and perpetuation of rheumatoid arthritis.The autoimmune reaction in rheumatoid arthritis consists of activated Cd 4+ T cells. These T cells apparently function mainly by stimulating the joint to produce cytokines that are central mediators of synovial reaction which leads to joint destruction. These T cells have been shown to contain 5-20 times more activity of enzyme Adenosine deaminase than other lymphocytes.The physiological activity of ADA is related to lymphocytic proliferation and differentiation. The levels of ADA are elevated in diseases in which there is a cell mediated immune response as is seen in rheumatoid arthritis (3) therefore determination of serum ADA activity can be a useful indicator of increased lymphoreticular activities and can be used as a marker of cell mediated immunity in rheumatoid arthritis.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Study of Serum Adenosine Deaminase and Alkaline Phosphatase in Rheumatoid Arthritis

Osmani¹,

Sayeed²,

Ali³

2015

jemds

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“…Increased activity of alkaline phosphatase has been found in pathological processes such as liver impairment, kidney dysfunction and bone diseases, and has been attributed to significant liver damage (Kendall et al, 1970). Alkaline phosphatase is a membrane-bound enzyme found at the bile pole of hepatoctyes (Garnero and Delmas, 1993).…”

Section: Discussion:-mentioning

confidence: 99%

Toxicity Study of Lead Nitrate on Freshwater Fish Cirrhina Mrigala.

Fernandes¹

2016

IJAR

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Chemicals present in the environment tend to alter the physiology of flora and fauna. Heavy metals tend to accumulate in the biosphere by virtue of their non-biodegradable nature. It is known that accumulation of heavy metals in tissues and organs results in cellular and molecular damage in various species (Cestari et al., 2004;Flora et al., 2012). The present study demonstrates the morphological and biochemical effects associated with the accumulation of the heavy metal lead in adult fish, Cirrhina mrigala (Common Indian Carp). Adults of Cirrhina mrigala were exposed to increasing concentrations of lead nitrate for a span of 96 hours, post which anatomical and biochemical changes were monitored. External morphology of adult fish and that of the liver and intestine were also qualitatively examined. The liver of treated fish appeared enlarged and had more mass compared with the control, whereas the intestine showed discolouration indicating ingestion of lead. Enzymes indicating stress and cellular damage were assayed in liver extracts prepared from exposed fish. The enzymes studied were succinate dehydrogenase, alanine transaminase, aspartate transaminase, acid phosphatase and alkaline phosphatase. A significant increase was foundin the activity of all of the enzymes except succinate dehydrogenase probably indicating hepatotoxicity. Succinate dehydrogenase activity was seen to have decreased, possibly indicating oxidative stress. Analysis of the neural marker enzyme acetylcholinesterase in brain extracts from these fish also showed a significant decrease in its activity which could lead to a misregulation in neurotransmission. These results directly reflect on the toxicity caused by accumulation of lead in the adult fish.Copy Right, IJAR, 2016,. All rights reserved.

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“…Abnormalities of liver function tests have previously been reported in patients with rheumatoid arthritis (RA) (Kendall et al, 1970;Hilton et al, 1974;Webb et al, 1975). It has generally been assumed that such patients had liver disease in association with RA, eg, primary biliary cirrhosis or coincidental and unrelated primary hepatic pathology.…”

mentioning

confidence: 98%

Gamma glutamyl transpeptidase levels in arthritis: a correlation with clinical and laboratory indices of disease activity.

Lowe¹,

Pickup²,

Dixon³

et al. 1978

Annals of the Rheumatic Diseases

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suMMARY Gamma glutamyl transpeptidase (GGTP) was measured in 62 patients with rheumatoid arthritis (RA) and 27 with osteoarthrosis (OA). The values for GGTP were significantly higher in the subjects with RA compared with the OA group. The prevalence of elevation of GGTP was higher in the RA subjects (77 %) than in the OA patients (33 %). Levels of GGTP correlated significantly with a number of objective indices of activity of RA in a separate group of 28 patients. Following treatment with penicillamine, GGTP levels showed a significant drop towards normal levels.

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Raised serum alkaline phosphatase in rheumatoid disease. An index of liver dysfunction?

Cited by 85 publications

References 11 publications

Study of Serum Adenosine Deaminase and Alkaline Phosphatase in Rheumatoid Arthritis

Study of Serum Adenosine Deaminase and Alkaline Phosphatase in Rheumatoid Arthritis

Toxicity Study of Lead Nitrate on Freshwater Fish Cirrhina Mrigala.

Gamma glutamyl transpeptidase levels in arthritis: a correlation with clinical and laboratory indices of disease activity.

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