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Serum substance P: an indicator of disease activity and subclinical inflammation in rheumatoid arthritis

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Abstract

The aim of the is study is to examine the role of serum substance P (SP) levels as a simple biomarker for rheumatoid arthritis (RA) disease activity, its correlation with other markers of disease activity, and with selected clinical parameters. The study comprised 90 RA patients and 24 healthy controls. RA activity was assessed by means of the disease activity 28-C-reactive protein (DAS28-CRP) index and ultrasound power Doppler (USPD) by the German ultrasound score based on seven joints. SP serum values were obtained by means of an ELISA commercial kit. Statistics were achieved by the Student’s t test and Spearman correlation analysis with Bonferroni correction. As a group, RA patients had significantly increased levels of SP compared with healthy controls (p < 0.0001). SP levels correlated with DAS28-CRP (r = 0.5050, p < 0.0001), number of tender joints (NTJ, r = 0.4668, p < 0.0001), number of swollen joints (NSJ, r = 0.4439, p < 0.0001), visual analogue scale (VAS, r = 0.5131, p < 0.0001). However, SP did not correlate with CRP levels (r = 0.0468, p = 0.6613), nor with the USPD (r = 0.1740, p = 0.1009). Elevated serum SP is a common feature of RA patients, which also appears to correlate with clinical measurements of disease activity and with subjective clinical data (NTJ and VAS). Thus, although SP is higher in RA patients with high disease activity, it also detects subtle RA disease activity even in patients in apparent remission, which suggests its usefulness for therapeutic decisions.

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  • 08 May 2020

    Following publication, it was brought to the authors��� attention by Dr. Julia Toscano-Garibay that she did not participate as a reviewer of the final version of this manuscript prior to its submission and publication in Clinical Rheumatology.

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Acknowledgments

We acknowledge Dr. Julia Toscano-Garibay for valuable comments on the manuscript and Dr. Angelica Garcia-Martinez, from “Un kilo de ayuda A.C.” for in depth advice with statistic analysis. We thank the health professionals and nurses that facilitate our work at the Department of Rheumatology of the Hospital Juárez de México. We are deeply grateful to all patients and controls for their participation in this study. This work was supported by Hospital Juárez de México (HJM 2280/13-A).

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Correspondence to Rosa Elda Barbosa-Cobos.

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Serum substance P is a reliable marker of subtle disease activity in rheumatoid arthritis.

Serum substance P can be more reliable to follow up RA disease activity than CRP.

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Barbosa-Cobos, R.E., Lugo-Zamudio, G., Flores-Estrada, J. et al. Serum substance P: an indicator of disease activity and subclinical inflammation in rheumatoid arthritis. Clin Rheumatol 37, 901–908 (2018). https://doi.org/10.1007/s10067-017-3929-6

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