Halil Harman

Overlooked hematological markers of disease activity in rheumatoid arthritis.

The aim of this study was to investigate the relationship between hematological markers and disease activity in patients with rheumatoid arthritis (RA).

Levels of serum pentraxin 3, IL-6, fetuin A and insulin in patients with rheumatoid arthritis

OBJECTIVE The aim of this study was to investigate the relationship between disease severity and biochemical parameters such as pentraxin-3, fetuin-A, IL-6, insulin and HOMA-IR levels in patients with rheumatoid arthritis. METHODS This study included 60 patients with RA and 20 healthy controls. Serum pentraxin-3, fetuin-A, IL-6 and insulin concentrations were measured. Also, HOMA-IR values were calculated. Disease activity was assessed with Disease Activity Score (DAS28). To evaluate quality of life, the Health Assessment Questionnaire disability index was applied. RESULTS The serum values for ESR, CRP, pentraxin-3 and fetuin-A in patients with RA were found to be higher than control subjects (p values=0.001, 0.001, 0.000, 0.000, 0.01, 0.02, respectively). A positive correlation was evident between the DAS 28 score and IL6 levels (r=0.263, p=0.045). We found no correlation between the DAS28 score and HOMA-IR, the levels of pentraxin 3, fetuin A, insulin (p<0.05). Fetuin A levels were positively correlated with cumulative steroid dose (r=0.382, p=0.035). A statistically significant correlation was evident between presence of cardiovascular disease and HOMA-IR values in RA patients (r=0.437, p=0.032). CONCLUSION Elevated levels of pentraxin-3, fetuin-A, CRP, ESR might play a role in the pathogenesis of RA. Levels of fetuin-A, insulin HOMA-IR, pentraxin-3, CRP and ESR were not associated with clinical severity of the RA.

Comparison of fetuin-A and transforming growth factor beta 1 levels in patients with spondyloarthropathies and rheumatoid arthritis.

We investigated the serum transforming growth factor beta 1 (TGFβ1) and fetuin‐A levels, and determined the relationships between these biomarkers and disease activity, mobility and radiologic progression in patients with spondyloarthropathy (SpA) and rheumatoid arthritis (RA).

Clinical and ultrasonographic findings in patients with early rheumatoid arthritis: an 18-month follow-up cohort study

Objectives: The aim of our study is to perform the clinical, functional and ultrasonographic (US) follow-up of the early and very early RA patient which is naive among the disease modifying antirheumatic drugs (DMARDs) for 18 months and evaluate the relationship of these parameters with the radiological final state. Material and methos: This prospective study included 48 early RA (15 very early RA) patients. Gray scale US (GSUS), Power Doppler US (PDUS) examinations, DAS 28, HAQ, ESR, CRP were repeated at each visit (baseline, 1, 3, 6, 9, 12, 18 months). Hand, wrist, elbow, shoulder, knee joints and hand, wrist tendon structures were evaluated via GSUS and PDUS. Results: The improvement in the ESR, CRP levels is observed in the 1st month of the treatment (p=0.006). The statistically significant improvement in the HAQ, DAS 28 scores, total GSUS synovitis score, total PDUS tenosynovitis score, total GSUS tenosynovitis score, and total PDUS tenosynovitis score begins only in the 3rd month (p=0.007, p=0.003, p=0.001, p=0.009, p=0.002, p=0.004 respectively). In the laboratory, US monitoring of very early RA patients, it is similar to early RA patients. In the multiple linear regression model, only total GSUS synovitis scores, total PDUS synovitis scores at baseline and 1st continued to show an effect on the radiographic progression scores in the early RA patients (β=0.417, p=0011; β=0.549, p=0.028; β=0.476, p=0015; β=0.358, p=0.017, respectively). Conclusions: Radiographic damage progresses at the similar severity in early and very early RA patients. The most important factor affecting the radiographic damage progression is the severity of US synovitis at the baseline and in the 1st month, independently of the disease activity.

Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study

We determined ankle pathologies in patients with different types of inflammatory rheumatic diseases using high‐resolution ultrasonographic (US) images, and compared the findings among the different patient groups.

Identification of ESM-1 as a new endothelial biomarker in the pathogenesis of rheumatoid arthritis

ABSTRACT The aim of this study was to investigate the use of ESM-1 (endothelial cell-specific molecule-1) as a new biomarker for the pathogenesis of rheumatoid arthritis (RA). The study cohort was divided into four groups according to the DAS28 disease activity score: 16 patients were classified as being in remission (DAS28 < 2.6), 16 patients exhibited low disease activity (DAS28: 2.6–3.2), 20 patients exhibited moderate disease activity (DAS28: 3.2–5.1) and 16 patients exhibited high disease activity (DAS28 > 5.1); 20 healthy subjects were included as a control group. Serum samples were gathered from the patients with documented seropositivity for rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies in order to assess RF IgM and ESM-1. ESM-1 levels were significantly higher in patients with RA than in healthy subjects (p = 0.035). The data presented here strongly indicate ESM-1 as an attractive target for the treatment of inflammation-related diseases, such as RA.

A New Explanation of Inflammation in Rheumatoid Arthritis Patients With Respect to Claudin-5, Matrix Metalloproteinase-9, and Neuroserpin

Objectives This study aims to investigate the relationship between neuroserpin (NSP) and claudin-5, as well as matrix metalloproteinase-9 (MMP-9), with respect to clinical activity of disease in patients with rheumatoid arthritis. Patients and methods The study included a total of 75 patients (18 males, 57 females; mean age 48.12±11.23 years; range 20 to 60 years) who were admitted to the rheumatology outpatient facility at the Medical Faculty Hospital, Sakarya University, in October 2014. Patients were divided into four groups based on their Disease Activity Score 28 (DAS28) scores as remission group (n=16, DAS28 <2.6), low disease activity group (n=16, DAS28 between 2.6-3.2), moderate disease activity group (n=28, DAS28 between 3.2-5.1), and high disease activity group (n=15, DAS28 >5.1). Ten healthy subjects (HS) served as controls. Results Claudin-5, MMP-9, and NSP levels were significantly different in rheumatoid arthritis patients compared to HS (p=0.035, 0.026, and 0.014, respectively). Additionally, there were no differences between claudin-5 levels and disease activity among all RA groups. However, compared to HS, patient groups showed a significant difference (p=0.035) in terms of claudin-5 levels. Serum levels of MMP-9 were significantly different in moderate disease activity group compared to HS (p=0.013). Levels of NSP were significantly different in moderate disease activity and high disease activity groups compared to HS (p=0.008 and 0.031, respectively). Conclusion Our study demonstrated the differential associations of endothelial function/dysfunction biomarkers and disease activity in rheumatoid arthritis. How and why this impairment occurs is not fully understood and more data regarding NSP, MMP, and claudin expression in plasma are warranted.