Increased adrenomedullin concentrations in patients with RA compared to those with OA

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J Rheumatol. 2003 Dec; 30(12): 2553-6.

Increased plasma and joint tissue adrenomedullin concentrations in

patients with rheumatoid arthritis compared to those with

osteoarthritis.

Chosa E, Hamada H, Kitamura K, Eto T, Tajima N.

Department of Orthopaedic Surgery and First Department of Internal

Medicine, Miyazaki Medical College, 5200 Kihara, Kiyotake, Miyazaki

889-1692, Japan. chosa@...

OBJECTIVE: To elucidate the pathophysiological role of adrenomedullin

(AM) in rheumatoid arthritis (RA), plasma AM concentration was measured

in patients with RA and in healthy contols. The concentration of AM in

joint fluid, synovial tissue, and articular cartilage of patients with

RA and osteoarthritis (OA) were measured and compared. METHODS:

Twenty-six patients with RA (aged 62 +/- 4 yrs, all female), 10 healthy

controls (aged 57 +/- 5 yrs, all female), and 10 patients with OA (aged

68 +/- 8 yrs, all female) were studied. We measured plasma levels of

total and mature AM by immunoradiometric assay and levels of AM in joint

tissue by radioimmunoassay. RESULTS: Plasma levels of AM in patients

with RA (18.35 +/- 6.9 fmol/ml) were found to exceed those in healthy

controls (11.64 +/- 2.8 fmol/ml). Moreover, plasma AM showed a

significant positive correlation with plasma C-reactive protein (CRP).

The correlation coefficient of total AM was 0.685, and that of mature AM

was 0.624. Similarly, AM levels in synovium and joint fluid in patients

with RA were significantly higher than in OA. In contrast, AM levels in

articular cartilage were found to be low, with no significant difference

in levels between patients with RA and OA.

CONCLUSION: The relation between plasma AM levels and plasma CRP in

patients with RA suggests that plasma AM levels increase with the

activity of RA. Moreover, AM levels in synovium and joint fluid of

patients with RA were significantly higher than those of patients with

OA. Thus, AM probably plays a part in the regulation of the inflammatory

process of RA.

PMID: 14719193

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