Associação dos marcadores de ativação endotelial, anticorpo antipeptídeo citrulinado cíclico e fator reumatoide com a atividade inflamatória e gravidade da artrite reumatoide
Arquivos
Data
2007
Autores
Teixeira, Roberto Cordeiro de Andrade 
Orientadores
Gabriel Júnior, Alexandre
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: 1- Estudar a ativação endotelial em pacientes com artrite reumatóide, correlacionando os marcadores molécula de adesão intercelular-1(ICAM-1), endotelina- 1 (ET-1), fator de vonWillebrand (vWF) e fator de crescimento endotelial (VEGF) com a atividade clínica e laboratorial da doença. 2- Avaliar possíveis correlações entre os níveis destes marcadores com auto-anticorpos Fator reumatóide (FR) e anticorpo antipeptideo citrulinado cíclico (anti-CCP) e a gravidade da doença. Casuística e Métodos: Em 38 pacientes e 24 indivíduos não reumatóides foram dosados FR, antiCCP, vWF, ICAM-1, ET-1 e VEGF no soro (Nefelometria, Imunoturbidimetria e EIA). A atividade da doença foi definida pelo escore do DAS28. O HAQ (Health Assessment
Questionnaire) definiu a capacidade funcional e os critérios revisados do American
College of Rheumatology (ACR) a classe funcional. Radiografias de mãos e punhos
quantificaram o índice de Sharp modificado. Na análise estatística foram empregados
os testes qui-quadrado, teste T, teste de Kolmogorov-Smirnov, Mann-Whitney e o
coeficiente de correlação de Spearman. Resultados: A idade dos pacientes foi de 52 ±
12,5 anos e dos indivíduos normais de 49 ± 9,4 anos. O tempo de doença foi de 68 ±
66,6 meses. O vWF apresentou correlação significativa com o tempo de evolução da
doença, (r= 0,340; p= 0,037 ), os auto-anticorpos com o índice de Sharp, FR (r= 0,529;
p= 0,001) anti-CCP (r= 0,415; p= 0,10). A correlação do vWF e da ICAM-1 foi
significativa com o DAS-28 (r= 0,374*; p=0,021) e (r= 0,338; p= 0,038)
respectivamente, o vWF se correlacionou com o HAQ (r= 0,355; p= 0,029) e com o
Sharp (r= 0,564; p= <0,001). A ET-1 não teve correlação significante com nenhuma
variável. O VEGF não se correlacionou significativamente com nenhuma variável.
Conclusões: Os auto-anticorpos e os marcadores endoteliais, exceto o vWF não se
correlacionaram com o tempo de doença. O FR e o anti-CCP se correlacionaram com o
Índice de Sharp. O vWF apresentou correlação significativa com atividade e gravidade
da doença, através da correlação com o DAS28 e com o Sharp. O ICAM-1 teve
correlação significativa com o FR, mas não com o anti-CCP. No presente estudo a ET-
1 não mostrou ser um bom marcador endotelial para AR.
Objectives: 1 – To study endothelial activation in patients with rheumatoid arthritis, by establishing correlations among specific markers (intercellular adhesion molecule-1 (ICAM-1), endotheline-1 (ET-1), von Willebrand factor (vWF) and vascular endothelial growth factor (VEGF)) with clinical and laboratorial activities of the disease; 2 – To evaluate possible correlations among the levels of those markers and rheumatoid factor (anti-RF), anti-cyclic citrullinated peptide autoantibody (anti-CCP) and the severity of the disease. Casuistic and Methods: In 38 patients and 24 non-rheumatoid individuals the following elements were dosed: RF, anti-CCP, vWF, ICAM-1, ET-1 and serum VEGF (nefelometry, imunoturbidimetry and EIA). Disease activity was determined by using the DAS28 score. HAQ (Health Assessment Questionnaire) defined the functional ability and the revised criteria of the American College of Rheumatology (ACR) defined the functional class. Hand and fist radiographs quantified the modified Sharp index. On statistical analysis tests employed were: qui-square test, T test, Kolmogorov-Smirnov test, Mann-Whitney test and Spearman’s correlation coefficient. Results: Patient age range was 52 ± 12,5 years and in normal individuals age variation was 49 ± 9,4. Disease time was 68 ± 66,6 months. Significant correlations were found between vWF and disease evolution time and also between autoantibodies and the Sharp index. Correlation of vWF and ICAM-1 were significant with DAS-28 and vWF was correlated with HAQ and with the Sharp index. ET-1 did not show significant correlations with any variable. VEGF was not found in significant correlation with any variable. Conclusions: Autoantibodies and endothelial markers, with the exception of vWF did not show correlations with disease time. RF and anti-CCP were correlated with the Sharp index. A significant correlation was found between vWF and disease activity and severity, through a correlation with DAS28 and Sharp. ICAM-1 had a significant correlation with RF but not with anti-CCP. In the present study ET-1 did not prove itself as an efficient marker for rheumatoid arthritis.
Objectives: 1 – To study endothelial activation in patients with rheumatoid arthritis, by establishing correlations among specific markers (intercellular adhesion molecule-1 (ICAM-1), endotheline-1 (ET-1), von Willebrand factor (vWF) and vascular endothelial growth factor (VEGF)) with clinical and laboratorial activities of the disease; 2 – To evaluate possible correlations among the levels of those markers and rheumatoid factor (anti-RF), anti-cyclic citrullinated peptide autoantibody (anti-CCP) and the severity of the disease. Casuistic and Methods: In 38 patients and 24 non-rheumatoid individuals the following elements were dosed: RF, anti-CCP, vWF, ICAM-1, ET-1 and serum VEGF (nefelometry, imunoturbidimetry and EIA). Disease activity was determined by using the DAS28 score. HAQ (Health Assessment Questionnaire) defined the functional ability and the revised criteria of the American College of Rheumatology (ACR) defined the functional class. Hand and fist radiographs quantified the modified Sharp index. On statistical analysis tests employed were: qui-square test, T test, Kolmogorov-Smirnov test, Mann-Whitney test and Spearman’s correlation coefficient. Results: Patient age range was 52 ± 12,5 years and in normal individuals age variation was 49 ± 9,4. Disease time was 68 ± 66,6 months. Significant correlations were found between vWF and disease evolution time and also between autoantibodies and the Sharp index. Correlation of vWF and ICAM-1 were significant with DAS-28 and vWF was correlated with HAQ and with the Sharp index. ET-1 did not show significant correlations with any variable. VEGF was not found in significant correlation with any variable. Conclusions: Autoantibodies and endothelial markers, with the exception of vWF did not show correlations with disease time. RF and anti-CCP were correlated with the Sharp index. A significant correlation was found between vWF and disease activity and severity, through a correlation with DAS28 and Sharp. ICAM-1 had a significant correlation with RF but not with anti-CCP. In the present study ET-1 did not prove itself as an efficient marker for rheumatoid arthritis.
Descrição
Citação
TEIXEIRA, Roberto Cordeiro de Andrade. Associação dos marcadores de ativação endotelial, anticorpo antipeptídeo citrulinado cíclico e fator reumatoide com a atividade inflamatória e gravidade da artrite reumatoide. 2007. 98 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2007.