Molecular markers of coagulation and fibrinolysis as indicators for the disease activity of rheumatoid arthritis

Abstract

Pathological roles of coagulation and fibrinolytic system are suggested in the progressive and destructive articular lesions of rheumatoid arthritis (RA). In the present study, we simultaneously and serially determined recently available molecular markers of coagulation (thrombin-antithrombin III complex; TAT) and fibrinolysis/fibrinogenolysis [fibrin/fibrinogen degradation products (FDP),d-dimer and FDP-E], and compared their circulating levels with conventional indicators for the disease activity of RA in 31 patients. Either TAT,d-dimer or FDP-E levels well correlated with Lansbury activity index (LAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. Compared with CRP levels, these hemostatic markers more strongly associated with LAI. In addition, the molecular marker levels correlated with each other in RA patients. The hemostatic markers were further determined on at least two different occasions in 14 RA patients. Percentage changes of thed-dimer level significantly associated with those of LAI, as observed between LAI and ESR or CRP levels. Our results clearly indicate excessive coagulation and fibrinolysis in active RA patients. Among the molecular markers determined,d-dimer was considered to be especially useful as a clinical indicator for disease activity of RA.