Serum Dickkopf-1 as a potential prognostic marker in patients with rheumatoid arthritis

Dina A Ali,Reham Lotfy Yonis,Haidy Ali Mohammed,Radwa Mahmoud El-Sharaby,Doaa Mohamed Esmail

doi:10.1186/s43166-021-00088-9

Abstract

BackgroundRheumatoid arthritis (RA) is a disease of an autoimmune nature that involves all types of joints structures and manifested by chronic joints inflammations and thus their erosions and damage. Dickkopf-1 (DKK-1) is a molecule that has an inhibitory regulation of wingless/integrated genes (Wnt) pathway and has a major role in models of animals with arthritis or joint destruction. Increased DKK-1 levels are implicated in higher resorption of the bone in cases of rheumatoid arthritis and thus with higher probability for joint deformities, while low levels associated with formation of new bone by osteoblasts, we aimed to study the prognostic role of circulating Dickkopf-1 in rheumatoid arthritis.ResultsThe present study revealed that the DKK-1 levels were significantly increased in RA patients in relation to the control group (P=0.001). We found a significant positive correlation between DKK-1 level and ESR (P=0.001), Disease Activity Score (DAS 28) (P=0.001), the disease duration (P=0.001), and the presence of bone erosions in plain X-ray of hands (P =0.001). Moreover, we revealed that, at cutoff value 2150, the DKK-1 in RA has 90% sensitivity and 85% specificity.ConclusionsDKK-l serum level can be used as a potential prognostic biomarker for monitoring of joint erosions and destruction in RA patients. Furthermore, it could be a possible target molecule in the future therapy to control the process of joint destruction.

Highlights

Rheumatoid arthritis (RA) is a disease of an autoimmune nature that involves all types of joints structures and manifested by chronic joints inflammations and their erosions and damage
There was a significant increase in serum erythrocyte sedimentation rate (ESR), DKK-1, Rheumatoid factor (RF), C-reactive protein (CRP), and anti-CCP levels in patients in comparison with controls (P=0.001) (Table 1)
As regards ESR, we found that the values of ESR were significantly high in RA patients in comparison to healthy subjects (Table 1)

Summary

Introduction

Rheumatoid arthritis (RA) is a disease of an autoimmune nature that involves all types of joints structures and manifested by chronic joints inflammations and their erosions and damage. RA is chronic disease of an autoimmune nature that causes inflammation in the synovial membrane, resulting in invasion of the near cartilaginous matrix by synovial tissue, that leads to the cartilage and bone degradation inside the joints. These bone erosions are often seen in imaging as marginal erosions of the joint, and it is a predictive of a worse prognosis for the disease [1, 2]. This Wnt signaling pathway is regulated by many groups of negative regulators, and one of these regulators is Dickkopf-1 (DKK-1) [7, 8]

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