Abstract
Clusterin (CLU) is a molecular chaperone that participates in a variety of biological processes. Recent studies indicate its possible involvement in the development of bone erosions and autoimmunity. The aim of this study was to investigate its serum concentrations in patients with early rheumatoid arthritis (RA) and to explore their potential relationship with disease activity and treatment response. Serum levels of CLU were measured in 52 patients before and 3 months after the initiation of treatment and in 52 healthy individuals. CLU levels at baseline were significantly increased in patients with early RA compared with healthy subjects (p < 0.0001). After 3 months of treatment, the levels of CLU decreased and reached concentrations comparable to those in controls. Even though there was no relationship between CLU levels and disease activity at baseline, CLU levels positively correlated with disease activity at months 3, 6 and 12 after treatment initiation. Using ROC analysis, lower CLU baseline levels predicted achieving the therapeutic target of low disease activity and remission at months 3, 6 and 12. In summary, we found increased serum concentrations of clusterin in treatment-naïve patients with early rheumatoid arthritis, and we suggest clusterin as a predictive biomarker of disease activity and treatment response.
Highlights
Clusterin (CLU) is a molecular chaperone that participates in a variety of biological processes
The expression of CLU has been demonstrated in a wide variety of tissues, especially at the sites of fluid-tissue interfaces[10], and its dysregulation is associated with diverse disease states, including c ancer[11], Crohn’s disease[12], osteoarthritis (OA)[13] and R A14
Disease activity was evaluated by the Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI) and 28-joint Disease Activity Score (DAS28) using the erythrocyte sedimentation rate (ESR), the number of tender and swollen joints and the patient’s global visual analogue scale (VAS) at baseline and at months 3, 6, and 12 after treatment initiation
Summary
Clusterin (CLU) is a molecular chaperone that participates in a variety of biological processes. The aim of this study was to investigate its serum concentrations in patients with early rheumatoid arthritis (RA) and to explore their potential relationship with disease activity and treatment response. Serum levels of CLU were measured in 52 patients before and 3 months after the initiation of treatment and in 52 healthy individuals. Using ROC analysis, lower CLU baseline levels predicted achieving the therapeutic target of low disease activity and remission at months 3, 6 and 12. We found increased serum concentrations of clusterin in treatmentnaïve patients with early rheumatoid arthritis, and we suggest clusterin as a predictive biomarker of disease activity and treatment response. Serum concentrations of CLU were found to be lower in patients with hand OA, especially in those with erosive disease, than in healthy individuals[20]. CLU has been suggested to exhibit a protective function in inflammation and autoimmune d iseases[21]
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