Serum Levels And Clinical Significances Of Soluble CD44v5 In Patients With Rheumatoid Arthritis

Objective:To examine serum levels of soluble CD44v5 in patients with rheumatoid arthritis(RA)and analyze the relevances between soluble CD44v5 and activity indexes of RA and evaluate the clinical significances.Methods:The subjects were divided into five groups:35 patients with active RA,31 paitents with remissive RA,31 patients with osteoarthritis(OA),31 patients with ankylosing spondylitis(AS),31 healthy controls.20 patients of active RA group took leflunomide for three months.The core indicators of RA activity is evaluated:the patients' pain score,morning stiffness,tender joint and swollen joint counts,tender joint and swollen joint index,Health Assessment questionnaire scores(HAQ),rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),different X-ray stages,disease activity score(DAS),extra-articular manifestations.Serum levels of soluble CD44v5 were measured by enzyme-linked immunosorbent assay(ELISA),and analyze the relevances between soluble CD44v5 and activity indexes of RA.Results:The levels of soluble CD44v5 in active RA group were significantly elevated compared with the levels in remissive RA,OA,AS group and healthy controls(P＜0.05);the levels in remissive RA group were higher than those in OA,AS group and healthy controls(P＜0.05);No notable difference was found in the levels among remissive RA,OA,AS groups(P＞0.05);The levels of phaseⅠ,Ⅱ,Ⅲ,Ⅳat X-ray stages elevated by turns and the level was significantly different between phaseⅡwith phaseⅠ,phaseⅢwith phaseⅡ,phaseⅣwith phaseⅢ,(P＜0.05);The level in RA with extra-articular manifestations was higher than those in RA without extra-articular manifestations,but no significantly different between the two groups(P＞0.05);There was positive correlation between the level of soluble CD44v5 with the patients' pain score,morning stiffness,tender joint and swollen joint counts, tender joint and swollen joint index,HAQ,DAS,RF,ESR,CRP.but the level of soluble CD44v5 didn't correlate with age,course of disease,anti-CCP antibody;After application of LEF for three months in 20 patients with active RA,Indicators of RA activity were significantly lower than those on admission,and the levels of soluble CD44v5 reduced(P＜0.05).Conclusion:①The levels of soluble CD44v5 in RA,especially in active RA,were significantly elevated compared to those in controls,and the levels of phaseⅠ,Ⅱ,Ⅲ,Ⅳat X-ray stages elevated by turns.So CD44v5 may be involved in the occurrence and development of RA and predict the degree of articular destruction.②The levels of soluble CD44v5 in active RA group were higher than those in remissive RA,and there was positive correlation between the elevated levels of soluble CD44v5 with the inflammatory activity of disease,After treatment,the levels of soluble CD44v5 reduced,It indicate the CD44v5 can partly reflect activity of RA.③The level in RA with extra-articular manifestations was higher than those in RA without extra-articular manifestations,but no significantly different between the two groups,So there is probably no relation between CD44v5 with extra-articular manifestations.