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Elevated Serum Levels of Calprotectin (Myeloid-Related Protein 8/14) in Patients With Ankylosing Spondylitis and Its Association With Disease Activity and Quality of Life

Background Calprotectin is one of the major leukocyte S100 proteins showing both calcium binding and antimicrobial characteristics. The serum level of calprotectin is markedly elevated in patients with inflammatory bowel disease, rheumatoid arthritis, as well as systemic lupus erythematosus and has been suggested to play a prominent role in both progression and pathogenesis of these diseases. Aim The purpose of this study was to investigate the serum level of calprotectin in patients with ankylosing spondylitis (AS) and its association with disease activity and other clinical characteristics of AS. Materials and Methods Thirty-one patients who met the modified New York criteria for AS and 45 healthy controls were included in this study. Both Bath AS disease activity index and AS disease activity score were applied on the patients with AS for the assessment of disease activity; Bath AS functional index, for the assessment of functional activity; Bath AS radiology index, for the assessment of radiological damage; and the AS quality of life questionnaire for the assessment of disease-related life status. Spinal and hip measurements were performed using Bath AS metrology index. The serum level of calprotectin was determined using enzyme-linked immunosorbent assay kit. Results Mean serum level of calprotectin was significantly higher in the patients with AS compared with healthy controls (P = 0.003). Serum levels of calprotectin did not correlate with Bath AS disease activity index, AS disease activity score, Bath AS functional index, Bath AS radiology index, Bath AS metrology index, modified Schober, chest expansion, AS quality of life questionnaire, erythrocyte sedimentation rate, and C-reactive protein values (P > 0.05). Conclusions Our results suggest that calprotectin might play an important role in the pathogenetic mechanisms of AS; however, the calprotectin levels did not correlate with the measurements of disease activity, functional abilities, radiological damage, and the quality of life in these patients. Further insight into this area of research might provide opportunities to develop novel treatment strategies, which take into account the role of these peptides in the pathogenetic mechanisms of AS.

Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia

Abstract Objective This study was performed to investigate serum prolidase enzyme activity and oxidative stress in patients diagnosed with fibromyalgia (FM). Methods The study population consisted of 40 patients with a previous diagnosis of FM and 30 healthy subjects. We measured serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) levels. Results On average, FM patients were diagnosed within 3.2 years of symptom onset, and patients had a mean of 14 tender points. There were no significant differences between patients and controls in age, body mass index, serum TAS, or PON-1 levels. However, patients with FM demonstrated higher serum prolidase activity, TOS, and OSI than the control group. Serum prolidase activity was positively correlated with serum TOS, OSI, and visual analog scale pain and fatigue scores. No correlation was found between serum prolidase activity and FM duration or the average number of tender points. Discussion Our results demonstrate a previously unreported association between serum prolidase enzyme activity and FM. Increased prolidase activity may contribute to the pathogenesis of FM, and measuring serum prolidase enzyme activity may be a useful FM biomarker.

Serum prolidase enzyme activity and oxidative status in patients with Behçet's disease

Abstract Objectives To assess serum prolidase enzyme activity and oxidative stress in patients with Behçets disease (BD). Methods The study population consisted of BD patients (n = 42) and healthy participants (n = 29). BD patients were classified as active (n = 18) or inactive (n = 24) according to disease activity. Serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and malondialdehyde (MDA) levels were measured. Results In BD patients with active disease, serum prolidase activity was significantly higher compared with the inactive and control participants. Serum prolidase activity was also significantly higher in all BD patients in comparison with controls. Serum prolidase activity was also positively correlated with OSI, C-reactive protein, and active BD. MDA, TOS, and OSI levels were all significantly higher in the BD group when compared with the healthy control participants. Serum TAS levels were significantly lower in BD patients in comparison with healthy controls. Conclusion High prolidase activity may indicate critical biological activities relevant to pathological events in BD, and this activity may be a biological indicator of disease. Further studies are needed to verify these findings.

Sex and thyroid hormone status in women with rheumatoid arthritis: are there any effects of menopausal state and disease activity on these hormones?

There has been considerable interest in the role of hormones in the aetiopathogenesis of rheumatoid arthritis (RA). In this study, we aimed to investigate sex and thyroid hormone conditions according to menopausal state and disease activation in RA women. Fifty‐four women with RA were included in the study. Age‐matched 28 women with low back pain were used as controls. Sex and thyroid hormones were evaluated in all patients, which included the measurement of estradiol (E2), progesterone, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), testosterone, thyroid‐stimulating hormone (TSH), total (T) and free (F) triiodothyronine (T3) and (T) and (F) thyroxine (T4). The RA patients were subdivided according to their pre‐menopausal and post‐menopausal status and their disease activation conditions. Mean age was 45.68 (±12.5) in women (aged 22–70) with RA and 42.39 (±12.45) in controls (aged 22–62). There were no significant differences in sex hormones, but there were statistically significant higher levels of TT3 and TT4 in whole women with RA compared to controls. Lower concentrations of FSH were detected in active RA patients. There were statistically lower concentrations of LH and higher concentrations of TT3 and TT4 in pre‐menopausal RA women, while lower concentrations of FSH were detected in post‐menopausal RA women. TT3 and FT3 levels of pre‐menopausal RA women were significantly higher than post‐menopausal RA women. There were no significant differences for all other hormones studied. In conclusion, sex and thyroid hormones have been influenced in women with RA. Reproductive and menopausal conditions should be taken into consideration when sex and thyroid hormones studies are carried out in RA women.

Elevated serum levels of calprotectin (MRP8/MRP14) in patients with Behçet's disease and its association with disease activity and quality of life

Abstract Background. Behçets disease (BD) is an inflammatory disease with multisystem chronic vasculitis. The disease is characterized by attacks of oral and genital ulcerations, skin lesions, arthritis, uveitis and deep vein thrombosis. The main histopathological feature is known to be vascular inflammatory change. Calprotectin (MRP8/MRP14) has been identified as an important alarmin that is expressed by activated phagocytes, granulocytes, monocytes and vascular endothelial cells, recognized by toll-like receptors, and induces a thrombogenic and inflammatory response in human microvascular endothelial cells. Aim. We aimed to investigate the serum levels of calprotectin in patients with BD and its association with disease activity and quality of life. Materials and methods. Forty-eight patients (25 males and 23 females) and 47 healthy controls (29 males and 18 females) were included to study. BD Current Activity Form (BDCAF) was used to assess the disease activity of patients with BD. Quality of life was assessed by using the Nottingham Health Profile (NHP). Depression and anxiety symptoms were assessed by using the Hospital Anxiety and Depression Scale (HADS). Serum level of calprotectin was determined using an ELISA kit. Results. Serum levels of calprotectin was significantly higher in patients with BD compared to healthy controls (p = 0.001). Serum levels of calprotectin did not correlate with the sores of BDCAF, NHP and HADS. Conclusion. Calprotectin may play a significant role in the pathogenetic mechanisms of BD. Further insight into this area of research might provide opportunities to develop novel treatment strategies.

Serum levels of high mobility group box 1 protein and its association with quality of life and psychological and functional status in patients with fibromyalgia

High mobility group box 1 protein (HMGB1) is a proinflammatory cytokine. Previous studies have suggested that HMGB1 can play an important role in the pathogenesis of many rheumatic diseases. The purpose of this study was to investigate the serum levels of HMGB1 in patients with fibromyalgia (FM) and its association with quality of life and psychological and functional status in these patients.

Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups (P < 0.001/P = 0.002). No statistically significant difference was found between the RA and the control groups (P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

Psychological health of caregivers and association with functional status of stroke patients

Abstract Objective: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients. Methods: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls. The functional state of patients was assessed by the Barthel Index (BI). Furthermore, emotional state of the caregivers was assessed by the Hospital Anxiety and Depression Scale (HADS) and their life quality was assessed by the SF36 Health Survey. Results: The mean anxiety (9.73 ± 4.88) and depression rates (9.81 ± 5.05) in the caregivers were significantly higher than those in controls (p<0.001, respectively). Significant impairments were observed in both their mental and physical health. Regression analysis also showed a significant negative correlation between the BI scores and the HADS scores. Conclusion: Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.

Association Between Neuropathic Pain, Pregabalin Treatment, and Erectile Dysfunction

INTRODUCTION The pathophysiology of erectile dysfunction (ED) may be vasculogenic, hormonal, anatomical, neurogenic, drug-induced and/or psychogenic in origin. Neuropathic pain (NP) may facilitate ED, because it is frequently associated with anxiety, depression, and its drug, pregabalin, may also contribute ED. AIM The objective of this study was to determine whether pregabalin treatment for patients with neuropathic pain promotes erectile dysfunction. METHODS The study sample consisted of a total of 102 male subjects that were subdivided into three groups. Group 1 patients (n = 31) had a pre-existing diagnosis of NP and was treated with 300 mg/day of pregabalin for at least 3 months. Group 2 patients (n = 34) were diagnosed with NP for at least 3 months; however, neither were they treated with pregabalin nor did they received physical therapy throughout the study. Lastly, healthy age-matched control subjects comprised group 3 (n = 37). MAIN OUTCOME MEASURES Patients in all groups completed the International Index for Erectile Function (IIEF) questionnaire. RESULTS Mean age and mean body mass index did not differ significantly between each of the three groups. The cause of NP and the mean duration of having a diagnosis of NP did not differ significantly in groups 1 and 2. However, IIEF scores were significantly lower for group 1 when compared to group 2 in terms of erectile function, orgasmic function, overall satisfaction and total score. Yet groups 1 and 2 did not diverge significantly in the intercourse satisfaction and sexual desire scores. Overall IIEF scores for group 3 were significantly higher than those of group 2 except for mean erectile function scores. CONCLUSION Taking pregabalin for the treatment of neuropathic pain poses an increased risk for developing ED in male patients. Thus, clinicians prescribing pregabalin to patients diagnosed with neuropathic pain should assess for ED before and during treatment with this medication.

Serum Coenzyme Q10 Levels and Oxidative Status in Patients with Fibromyalgia Syndrome

Abstract Objectives: The aim of this study was to determine the relationship between serum coenzyme Q10 [CoQ10] levels and symptoms of fatigue associated with fibromyalgia syndrome [FMS]. Methods: Patients diagnosed with primary FMS and domographically matching healthy normal controls [HNCs] were sought to participate in the study. The total antioxidant status, total oxidative status, and CoQ10 levels were measured in blood samples from the patients and the controls. Results: A total of 40 patients with FMS and 30 HNCs were recruited. There were no statistically significant differences between the two groups in regard to C-reactive protein, mean erythrocyte sedimentation rate, mean age, and mean body mass index [p > 0.05]. The mean time from symptom onset to diagnosis for the FMS patients was 2.88 years, and the average number of tender points was 14. The serum CoQ10 levels were significantly lower in the FMS patients compared with the HNC group [p = 0.000]. The serum total oxidative status and oxidative stress index levels were higher, and the serum total antioxidant status levels were lower in the FMS patients compared with those of the HNC group [p < 0.05]. The visual analog scale [VAS] pain scores and the VAS fatigue scores were significantly higher in the FMS group than in the HNC group [p = 0.000]. The serum CoQ10 levels were negatively correlated with the mean Modified Fatigue Impact Scale scores [p = 0.02, r = 0.30], VAS pain scores [p = 0.00, r = 0.38], and VAS fatigue scores [p = 0.03, r = 0.28]. Conclusions: The CoQ10 deficiency may contribute to the etiopathogenesis of FMS fatigue.