RESEARCH - Increased levels of CRP in serum from blood donors before the onset of RA

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Arthritis Rheum. 2004 Aug;50(8):2423-7.

Increased levels of C-reactive protein in serum from blood donors before

the onset of rheumatoid arthritis.

Nielen MM, van Schaardenburg D, Reesink HW, Twisk JW, van de Stadt RJ,

van der Horst-Bruinsma IE, de Gast T, Habibuw MR, Vandenbroucke JP,

Dijkmans BA.

Jan van Breemen Institute, Amsterdam, The Netherlands.

OBJECTIVE: We previously reported that approximately half of the

patients with rheumatoid arthritis (RA) have specific serologic

abnormalities (elevated serum concentrations of IgM rheumatoid factor

and/or anti-cyclic citrullinated peptide antibodies) starting several

years before the onset of symptoms. In this study, the presence of

serologic signs of inflammation in patients with preclinical RA was

investigated with serial measurements of C-reactive protein (CRP).

METHODS: Seventy-nine patients (61% female; mean age at onset of

symptoms 51 years) who had been blood donors before the onset of RA were

identified. Frozen serum samples from each donor were retrieved,

together with 1 sample from a control donor matched for age, sex, and

date of donation. CRP was measured using a highly sensitive

latex-enhanced assay. The dates of donation were categorized into 15

1-year periods preceding the onset of RA symptoms. For each period, the

median CRP levels in the patient and control groups were compared using

the Mann-Whitney U test. The course of CRP concentrations over time in

the patient group was estimated with random coefficient analysis.

RESULTS: A median of 13 samples (range 1-51) per patient were available;

the earliest donation was made a median of 7.5 years (range 0.4-14.5

years) before the onset of symptoms. A total of 1,078 patient samples

and 1,071 control samples were tested. For all 1-year periods, the

median CRP concentration was increased in the patient group compared

with the control group, but this difference was statistically

significant only for the periods 0-1 year, 1-2 years, and 4-5 years

before the onset of symptoms. The CRP concentration increased

significantly over time in patients with preclinical RA; levels were

slightly higher in the group of patients who had serologic abnormalities

before the onset of symptoms than in those without such serologic

abnormalities.

CONCLUSION: After observing specific serologic abnormalities 5 years

before the onset of RA symptoms, we now report increased levels of CRP

in blood donors in whom RA later developed; these increases were most

common within the 2 years before the onset of symptoms. The preclinical

increase in CRP levels was observed both in donors with and in those

without serologic abnormalities.

PMID: 15334453

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5334453 & dopt=Abstract

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