Synovitis evaluation in Egyptian patients with early rheumatoid arthritis

Background
Evaluation of synovitis in early rheumatoid arthritis (RA) is a crucial subject for appropriate management. Ultrasound (US) with high-resolution study has been confirmed a helpful aid in synovitis evaluation. Chemokine CXC ligand 13 protein (CXCL13), a potent B-cell chemoattractant, is expected to play a valuable role in pathobiology of RA.


Aim
To evaluate synovitis in early RA using serum CXCL13, US with high resolution, and power Doppler ultrasonography (PDUS), and their correlation with disease activity.


Patients and methods
A total of 40 patients with early RA fulfilling 2010 EULAR/ACR criteria of RA were assessed using disease activity score 28 for disease activity in RA, serum CXCL13, and US with high resolution. Moreover, 20 healthy age-matched and sex-matched patients were included as a control group.


Results
Serum CXCL13 levels were highly significantly increased in patients with early RA than controls (P<0.001). Regarding US with high resolution, patients with early RA had a significant increase in thickness of synovium and PDUS score compared with controls (P<0.001). In patients with early RA, serum CXCL13 significantly correlated with erythrocyte sedimentation rate, C-reactive protein, anti-cyclic citrullinated peptide, disease activity score 28, synovial thickness, and PDUS score. Moreover, there was a significant increase in serum CXCL13, synovial thickness, and PDUS score in patients with active RA when compared with patients with remitting RA (P<0.001).


Conclusion
Serum CXCL13 appears to be a new marker of synovitis in patients with early RA and correlates with thickening of synovium and PDUS scores that might reflect disease activity.