Abstract
Joint hypoxia plays a central role in the progression and perpetuation of rheumatoid arthritis (RA). Thus, optical techniques that can measure surrogate markers of hypoxia such as blood flow, oxyhemoglobin, deoxyhemoglobin, and oxygen saturation are being developed to monitor RA. The purpose of the current study was to compare the sensitivity of these physiological parameters to arthritis. Experiments were conducted in a rabbit model of RA and the results revealed that joint blood flow was the most sensitive to arthritis and could detect a statistically significant difference (p<0.05, power = 0.8) between inflamed and healthy joints with a sample size of only four subjects. Considering that this a quantitative technique, the high sensitivity to arthritis suggests that joint perfusion has the potential to become a potent tool for monitoring disease progression and treatment response in RA.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory arthropathy afflicting about 1% of the population [1]
The results of this study clearly demonstrate that joint blood flow was the most sensitive to inflammatory arthritis, there are few limitations that could potentially prevent the generalization of these results
A longitudinal study was conducted in a rabbit model of inflammatory arthritis
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory arthropathy afflicting about 1% of the population [1]. RA is typically diagnosed by clinical examination, patient self-assessment, and laboratory tests, which can be supplemented with diagnostic imaging (magnetic resonance imaging, MRI; ultrasonography, US; X-ray radiography) for improved accuracy [11,12,13,14]. This multipronged approach has proven to be highly effective in diagnosing RA [12]. The current practice is to use the same tools for both diagnostic and treatment monitoring [17] This is a major hindrance because, while the aforementioned methods are appropriate for one-time use (e.g., for diagnostic), they are not suitable for longitudinal assessment of joint inflammation in response to treatment. There is clearly a need for safe, fast, and inexpensive methods that can objectively assess treatment response with a sensitivity that rivals clinical examination and diagnostic imaging
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