Abstract
Introduction: To determine the effects of non-treated seronegative rheumatoid arthritis (RA) on proximal renal tubule, sensitivity of Alanine aminopeptidase (AAP), g-glutamyltransferase (g--GT), β2 microglobulin in urine β2M), as well as relation with rheumatoid factor (RF) and C-Reactive protein (CRP), DAS 28 disease activity index. Methods: RF was determined by agglutination test (Latex RF test, while kinetic methods were used for determination of Alanine aminopeptidase (AAP) and g-glutamyltransferase (g-GT), as well as MEIA (Micro particle Enzyme Immunoassay) to determine β2 microglobulin in urine. Samples (serum and urine) of 70 participants were examined (35 RA not treated, 35 health control group). Results: In 35 RF negative RA, AAP enzymuria was present in 12 (34.28%) patients, g-GT was present in 7 patients (20%), while β2 microglobulin was present in 3 patients (8.57%). In the healthy control group, 4 patients showed AAP positivity (11.42%), 2 patients g-GT positivity (5.71%) and 1 patient showed presence of β2 microglobulin in urine (2.85). RF was not present in any patient (0%). Conclusion: AAP has a higher sensitivity of g-GT and b2 microglobulin in the detection of asymptomatic renal lesions in non treated seronegative RA.
Highlights
To determine the effects of non-treated seronegative rheumatoid arthritis (RA) on proximal renal tubule, sensitivity of Alanine aminopeptidase (AAP), -glutamyltransferase ( --GT), β2 microglobulin in urine β2M), as well as relation with rheumatoid factor (RF) and C-Reactive protein (CRP), DAS 28 disease activity index
In 35 RF negative RA, AAP enzymuria was present in 12 (34.28%) patients, -GT was present in 7 patients
In patients included in the study, disease diagnose is based on the revised diagnostic criteria for classification of Rheumatoid arthritis proposed in 1987 by the American Rheumatism Association (ARA) [10,11,12,13]
Summary
To determine the effects of non-treated seronegative rheumatoid arthritis (RA) on proximal renal tubule, sensitivity of Alanine aminopeptidase (AAP), -glutamyltransferase ( --GT), β2 microglobulin in urine β2M), as well as relation with rheumatoid factor (RF) and C-Reactive protein (CRP), DAS 28 disease activity index. There are about 40 different enzymes [2,3,4,5,6] in the urine that belong to different groups: oxidoreductase, transferase, hydrolase, lyase, while isomerases and ligases are not found in the urine The occurrence of such large number of enzymes in the urine indicates the dominant role of kidneys in their excretion. Examination of the cell membranes of the brush epithelium of the proximal tubules confirms the localization of alanine aminopeptidase (AAP) in 90%, alaline phosphatase (AF) in 70% and -glutamyl transpeptidase ( -GT) in 50% of the total activity of these enzymes in the kidney [7,8,9]
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