Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: To optimize treatment for rheumatoid arthritis (RA), it is ideal to monitor disease activity on a daily basis such as glucose measurement since RA activity fluctuates over time. Urine can be collected routinely at home by patients themselves and tested for systemic inflammation. Recently, we had identified 4 urinary biomarker candidates– gelsolin (GSN), orosomucoid (ORM)1, ORM2, and soluble CD14 (sCD14)– in RA patients through transcriptomics and proteomics studies.
Methods: Here, we investigated the clinical significance of the aforementioned urinary biomarker candidates in a prospective manner, focusing on their role in predicting RA activity and providing prognosis. Urinary concentrations of the four proteins were determined by enzyme-linked immune-sorbent assay. RA activity and severity were determined by assessing disease activity score 28 and X-rays of hands and feet of patients, respectively.
Results: Urinary ORM1, ORM2, and sCD14 levels were elevated in RA patients. They were positively correlated with the status of the disease activity. In particular, urine determinations of one or two biomarkers (e.g. ORM1+ORM2 or sCD14+ORM2) efficiently represented the presence of high RA activity without the need for blood markers. In parallel, a more rapid radiographic progression in three years was observed in patients with higher ORM2 levels. In multivariate analysis, urinary ORM2 level was an independent risk factor for RA progression. Combination of urinary ORM2 and serum C-reactive protein synergistically increased the predictability for radiographic progression (the adjusted odds ratio: 46·5). In vitro functional studies revealed that ORM2 was mainly produced by RA synoviocytes in the joints, directly contributing to proinflammatory responses.
Conclusion: Our urinary biomarkers provide novel candidates for patient-driven measurements of RA activity at home and can shift the paradigm from blood to urine testing in the assessment of RA activity and prognosis in hospitals.
To cite this abstract in AMA style:Kim WU, Park YJ, Yoo SA, Hong BK, Kim GM, Choi S, Lee S, Cho CS. A Paradigm Shift in the Disease Assessment of Rheumatoid Arthritis : From Blood to Urine Testing [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-paradigm-shift-in-the-disease-assessment-of-rheumatoid-arthritis-from-blood-to-urine-testing/. Accessed January 17, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-paradigm-shift-in-the-disease-assessment-of-rheumatoid-arthritis-from-blood-to-urine-testing/