Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 Adrenomedullin Levels May Indicate Increased Disease Activity in Rheumatoid Arthritis A DGReview of : " Increased plasma and joint tissue adrenomedullin concentrations in patients with rheumatoid arthritis compared to those with osteoarthritis " Journal of Rheumatology 01/30/2004 By Deanna M Green, PhD Adrenomedullin levels are significantly higher in patients with rheumatoid arthritis (RA) than in patients with osteoarthritis or in healthy controls, according to results from plasma, synovium, and joint fluid samples. Measurements of adrenomedullin levels may be useful in assessing disease activity. Increased levels of plasma adrenomedullin have been reported in some collagenous and rheumatic disorders and may function in the regulation of inflammation. The role of adrenomedullin in RA, however, has not been investigated. Etsuo Chosa, MD, PhD, and colleagues at the Miyazaki Medical College, Japan, evaluated plasma adrenomedullin levels in patients with RA as compared to healthy controls and patients with OA. The study included 26 women with stage 4/class 2 RA, 10 healthy women, and 10 women with stage 4 or 5 OA. Adrenomedullin levels were measured in whole blood samples from all participants and in joint fluid, synovial tissue, and cartilage acquired during total knee arthroplasty in 6 patients with RA and 6 with OA. Total and mature adrenomedullin plasma levels in RA patients were about 1.7 times higher than in healthy controls and about 1.4 times higher than in OA patients. Specifically, total adrenomedullin plasma levels were 18.35 fmol/mL in patients with RA, 12.88 fmol/mL in patients with OA, and 11.64 fmol/mL in healthy controls (P < .01 for RA vs. healthy and OA samples). Adrenomedullin levels were also significantly higher in the joint fluid and synovial tissue of RA patients when compared to OA patients. Adrenomedullin levels were highest in the synovial tissue, 156 fmol/g versus 51 fmol/g in patients with OA (P < .01). However, similar levels of adrenomedullin were seen in the articular cartilage. Notably, both total and mature plasma adrenomedullin levels correlated positively with plasma C-reactive protein levels (CRP). Since CRP levels have been found to correlate with disease activity and response to therapy, it could suggest that adrenomedullin levels may also correlate with disease activity. The authors conclude that " adrenomedullin probably plays a part in the regulation of the inflammatory process of RA, and its plasma and/or joint fluid levels could be used as an index of the degree of RA. " J Rheumatol 2003 Dec;30:12:2553-6 Quote Link to comment Share on other sites More sharing options...
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