Abstract
Objective: We measured the serum hyaluronic acid (HA) level and compared the grade of joint destruction with laboratory data of rheumatoid arthritis (RA) patients. Materials and methods: A sandwich-binding assay using hyaluronic acid binding protein (HABP) was used for measuring the serum HA level of 263 patients with (RA) and 19 healthy controls. Results: Serum HA level of patients with RA was shown to be higher (350.7±689.5 ng/ml) than that of healthy controls (33.7±24.2 ng/ml). No correlation between HA level and blood sedimentation ratio (BSR) was found, while C-reactive protein (CRP) showed a slightly increasing elevation of serum HA level. Because extreme wide variations of serum HA level were found in severe joint destruction in RA, we compared the serum HA level between active joint destruction cases and non-active ones. In comparison, within a year, the active cases showed a significantly higher serum HA level (1143.6±1746.0 ng/ml) than the non-active cases (245.3±255.8 ng/ml). Furthermore, in one of seven cases, followed up for 4 years, serum HA rose to an extremely high level (232.5±4535 ng/ml) accompanied by progressive joint destruction from grade III to grade IV (Larsen's grade) in bilateral knee joints, although no significant correlation was found between serum HA level and other laboratory factors such as BSR and CRP. Conclusion: The serum HA level demonstrates an active process of joint destruction, and the HA assay using (HABP) could be a useful marker for determining the process of joint destruction and for evaluating therapeutic effects in RA.
Published Version
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