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Bone alkaline phosphatase in rheumatic diseases

C Beyeler1, R E Banks, D Thompson

  • 1Department of Rheumatology, University of Berne, Switzerland.

Annals of Clinical Biochemistry
|July 1, 1995
PubMed
Summary

In rheumatoid arthritis (RA) and ankylosing spondylitis (AS), elevated total alkaline phosphatase (TAP) is not primarily from bone. Bone alkaline phosphatase (BAP) levels did not correlate with disease activity in these inflammatory rheumatic conditions.

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Area of Science:

  • Biochemistry
  • Rheumatology
  • Immunology

Background:

  • Elevated total alkaline phosphatase (TAP) is common in active rheumatoid arthritis (RA) and ankylosing spondylitis (AS).
  • The origin of elevated TAP (bone vs. liver) in these inflammatory rheumatic diseases is not fully understood.

Purpose of the Study:

  • To investigate whether elevated total alkaline phosphatase (TAP) in active rheumatoid arthritis (RA) and ankylosing spondylitis (AS) originates from bone or liver.
  • To assess the correlation between bone alkaline phosphatase (BAP), TAP, and disease activity in RA and AS.

Main Methods:

  • A double monoclonal immunoradiometric assay specific for bone alkaline phosphatase (BAP) was employed.
  • Fifty-eight RA patients, 14 AS patients, and 14 non-inflammatory rheumatic disease (NI) patients were studied.

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  • Disease activity was assessed using plasma viscosity; liver function was monitored via aspartate transaminase and gamma-glutamyl transferase (GGT).

    • Main Results:

    • Elevated BAP concentrations were found in a small subset of patients (7/86), with only two also having abnormal TAP.
    • Abnormal TAP activities were observed in only three RA patients.
    • BAP did not correlate with disease activity in RA or AS, whereas TAP and GGT correlated with plasma viscosity in RA.

    Conclusions:

    • The elevated TAP often seen in active RA and AS is unlikely to be primarily derived from bone.
    • While TAP and GGT correlate with disease activity in RA, BAP does not show this correlation.
    • Further investigation is needed to explain the complex relationships observed between TAP, BAP, GGT, and disease activity in inflammatory rheumatic diseases.