Some Diagnostic Aspect with Overall Clinical Expression of Asymmetric Dimethylarginine as an Hallmark for Evaluation of Subclinic Athrosclerosis in Patients with Rheumatoid Arthritis with Aspect on Abnormal Nitric Oxid Metabolism and Some Pharmacological Aspects of the Most Used Drugs in RA

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Introduction: To evaluate the diagnostic test for Asymmetric Dimethyl Arginine (ADMA), rheumatoid factor (RF), C-reactive protein (CRP), Disease Activity Score with 28 joint (DAS 28 index), and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease evolution, ADMA was used as an indicator for endothelial dysfunction in subclinical atherosclerosis. Methods: Using an ELISA technology of DLD-Diagnostic-GMBH for detection of ADMA, the samples of serum and urine have been examined in 70 participants (35 RA who were not treated, 35 healthy controls). RF was defined with the test for agglutination (Latex RF test) in the same participants. Results: Out of 35 examined patients with RA, RF appeared in 18 patients (sensitivity of the test 48.57%), while ADMA is positive in 20 patients (sensitivity of the test 57.14%) in the same group. In 23 of the 35 examined patients with RA, we found presence of anti-circulated peptide antibodies (anti-CCP2) from the second generation (anti- CCP2 antibodies) (sensitivity of the test 65.71%). There is association between ADMA and anti-circulated peptide antibodies (anti-CCP2) from the second generation in early RA (p<0.05). Conclusion: ADMA higher sensitivity than RF in the detection of asymptomatic subclinical lesions in untreated RA. ADMA has equal sensitivity and specificity from RF in untreated RA.