RESEARCH - Arthritis instantaneously causes collagen type-I and II degradation in patients with RA.

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Ann Rheum Dis. 2005 Aug 26; [Epub ahead of print]

Arthritis instantaneously causes collagen type-I and type-II degradation in

patients with early rheumatoid arthritis. A longitudinal analysis.

Landewe RB, Geusens P, van der Heijde D, Boers M, van der Linden S, Garnero

P.

University of Maastricht, Netherlands.

BACKGROUND: Radiographic damage in rheumatoid arthritis (RA) is thought to

be the result of chronic persistent arthritis. Parameters reflecting disease

activity and inflammation are predictors of radiographic progression, but it

is not known whether arthritis immediately influences the bone- and

cartilage of joints. It was found in the COBRA trial and the COBRA-

follow-up study that markers of collagen Type-I (CTX-1) and Type-II (CTX-II)

degradation, reflecting bone and cartilage breakdown, predict long-term

radiographic progression. OBJECTIVE: In this study we performed a

longitudinal analysis on whether changes in the extent of arthritis are

instantaneously followed by changes in the level of collagen Type-I

and -Type-II degradation. PATIENTS AND METHODS: Biomarkers (CTX-I and

CTX-II) were measured in the urines of 105 patients with early RA who had

participated in the COBRA trial at baseline and at 3,6,9 and 12 months after

the start of therapy. The course of the biomarkers over time was compared

with the course of ESR, swollen joint count, tender joint count, and DAS28,

measured at the same time points, with adjustment for rheumatoid factor,

treatment and baseline radiographic damage, by generalised estimating

equations (GEE) with first order auto-regression. RESULTS: GEE with first

order auto-regression showed that CTX-I was longitudinally associated with

DAS28, but not with ESR, swollen joint count, and tender joint count.

CTX-II, however, was longitudinally associated with ESR, swollen joint count

and DAS28, but not with tender joint count. The longitudinal association

implies that an increase in the extent of arthritis is immediately followed

by an increase in collagen Type-II degradation, and to a lesser extent

collagen Type-I degradation.

CONCLUSION: Cartilage degradation as measured by CTX-II and to a lesser

extent bone degradation as measured by CTX-I closely follows parameters of

arthritis, which strongly suggests that any clinically perceptible arthritis

in is responsible for immediate damage, that becomes visible on plain X-rays

only much later.

PMID: 16126801

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6126801 & dopt=Abstract

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