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Relationship between severity of rheumatoid arthritis and serum alpha 1-antitrypsin
R T Abboud1, A Chalmers, J P Gofton
1Respiratory Division, University of British Columbia, Vancouver General Hospital, Canada.
Abstract:
We determined serum alpha 1-antitrypsin phenotypes and levels in 281 patients with classical or definite rheumatoid arthritis (RA). The prevalence of the MZ phenotype in our patients with RA was not increased, as there were only 3 MZ cases (1.1% of all cases and 1.4% of seropositive cases) compared to the 3% prevalence in controls. The FM phenotype was detected in 6 cases, a prevalence rate of 2.1%, significantly higher than in controls (prevalence less than 0.4%). Increased serum levels of alpha 1-antitrypsin were independently associated (p less than 0.01) with the presence of wrist joint erosions and the use of gold and/or penicillamine for treatment; this association may represent a serum antitrypsin response to more severe disease.
Insights
The FM phenotype of alpha 1-antitrypsin was more common in rheumatoid arthritis (RA) patients. Increased serum alpha 1-antitrypsin levels correlated with RA severity, including wrist joint erosions and specific treatments.
Area of Science:
- Immunogenetics
- Rheumatology
- Protein Biochemistry
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation.
- Alpha 1-antitrypsin (AAT) is a key proteinase inhibitor with genetic variations.
- The association between AAT phenotypes/levels and RA is not fully understood.
Purpose of the Study:
- To investigate the prevalence of different alpha 1-antitrypsin (AAT) phenotypes in patients with rheumatoid arthritis (RA).
- To determine the relationship between serum AAT levels and clinical manifestations or treatment in RA patients.
Main Methods:
- Serum samples were collected from 281 patients diagnosed with classical or definite rheumatoid arthritis (RA).
- Alpha 1-antitrypsin (AAT) phenotypes (e.g., MZ, FM) and serum levels were analyzed.
- Statistical analysis was performed to compare RA patients with control groups and to assess associations with disease characteristics.
Main Results:
- The MZ phenotype prevalence was not elevated in RA patients compared to controls.
- The FM phenotype was significantly more prevalent in RA patients (2.1%) than in controls (<0.4%).
- Increased serum AAT levels were independently associated with wrist joint erosions (p<0.01) and treatment with gold or penicillamine.
Conclusions:
- The FM AAT phenotype may be a risk factor or marker associated with rheumatoid arthritis (RA).
- Elevated serum alpha 1-antitrypsin levels in RA patients might indicate a response to disease severity, particularly joint damage and specific therapies.