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Increased Plasma and Joint Tissue Adrenomedullin Concentrations in Patients with Rheumatoid Arthritis Compared to Those with Osteoarthritis
ETSUO CHOSA, HIROAKI HAMADA, KAZUO KITAMURA, TANENAO ETO, and NAOYA TAJIMA
ABSTRACT.
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. (J Rheumatol 2003;30:2553-6) Key Indexing Terms:
ADRENOMEDULLIN
From the Department of Orthopaedic Surgery and First Department of Internal Medicine, Miyazaki Medical College, Miyazaki, Japan. Supported in part by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan (13877245). E. Chosa, MD, PhD, Associate Professor; H. Hamada, MD, PhD; N. Tajima, MD, PhD, Professor, Department of Orthopaedic Surgery; K. Kitamura, MD, PhD, Assistant Professor; T. Eto, MD, PhD, Professor, First Department of Internal Medicine, Miyazaki Medical College. Address reprint requests to Dr. E. Chosa, Department of Orthopaedic Surgery, Miyazaki Medical College, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan. E-mail: chosa@post.miyazaki-med.ac.jp Submitted December 24, 2002; revision accepted April 17, 2003. |