Uromodulin Levels in Rheumatoid Arthritis
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 86
- Locations
- 1
- Primary Endpoint
- C.Acute-phase reactants (at least 1 test result is needed for classification)
Study Overview
Brief Summary
The aim of the present study was to evaluate the levels of uromodulin in rheumatoid arthritis (RA) and to investigate whether it was correlated with baseline clinical characteristics. In addition CKD epi,MDRD,urine microalbuminuria,pH,serum urea, creatinine,CRP (C-Reactive protein) were measured.The participants consist of ; %68 patients,% 32 control group.
Detailed Description
Uromodulin, also known as Tamm-Horsfall protein, is a protein abundantly excreted in the urine in healthy individuals. It is synthesized in the thick ascending limb of Henle (TALH) and the early distal convoluted tubule. Its biologic function is still obscure; however, some experimental studies indicated that it might serve as an important urinary defense factor against bacterial colonization and stone formation.
There are controversial publications on the frequencies of urinary tract infections and nephrolithiasis in patients with mutations of uromodulin gene. Deposition of mutated uromodulin in the urinary system may lead to tubular cell dysfunction and apoptosis. These alterations may subsequently cause tubular atrophy and interstitial fibrosis . Moreover, the release of abnormal uromodulin after apoptosis through basolateral secretion may elicit an immune response which may give rise to an immune-mediated tubulointerstitial nephritis .
Uromodulin can activate the other components of the immune system and may modulate the inflammatory and immune responses through different mechanisms .
Experimental studies yielded that uromodulin negative mice displayed splenomegaly with infiltration of white pulp by macrophages and increased levels of TNF-α and interleukin-1 . Rheumatoid arthritis is a systemic autoimmune condition that may eventually result in the joint damage, disability and premature mortality.
Study Design
- Study Type
- Observational
- Observational Model
- Case Control
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Patients who diagnosed of rheumatoid arthritis as criteria of ACR/EULAR
- •All patients age range is 18-80 years.
- •Exclusion Criteria :
- •Renal failure
- •Hepatic insufficiency
- •Diabetes mellitus
- •Other collagen vascular diseases,
- •History of smoking and consumption of alcohol
Exclusion Criteria
- Not provided
Arms & Interventions
healthy control
healthy person, similar population
Intervention: healthy control
ra patients
The diagnosis of RA was based on the criteria developed by the American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) in 2010 [8]. A drug history was obtained from every patient. All non-steroidal anti-inflammatory medications and disease-modifying antirheumatic drugs prescribed during the year before enrollment in the study were recorded. criteria included systemic diseases (renal failure, hepatic insufficiency, diabetes mellitus, other collagen vascular diseases, history of smoking and consumption of alcohol.In order to eliminate the possibility of any systemic disease therefore we choose that our control group as young.
Intervention: ra patients
Outcomes
Primary Outcomes
C.Acute-phase reactants (at least 1 test result is needed for classification)
Time Frame: 1 day
Normal CRP (C-reactive protein and normal) and normal ESR (erythrocyte sedimentation rate) (score 0) Abnormal CRP or abnormal ESR (score1)
Patients with rheumatoid arthritis
Time Frame: 1 day
The diagnosis of RA was based on the criteria the American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) in 2010. Patients selected 1. have at least 1 joint with definite clinical synovitis (swelling) 2. with the synovitis not better explained by another disease Classification criteria for RA (score-based algorithm: add score of categories A-D; a score of \>6/10 is needed for classification of a patient as having definite RA)
A.joint involvement
Time Frame: 1 day
1 large joint (score 0) 2-10 large joints (score 1) 1-3 small joints (with or without involvement of large joints)#(score2) 4-10 small joints (with or without involvement of large joints)(score 3) 10 joints (at least 1 small joint) (score 5)
B.Serology (at least 1 test result is needed for classification)
Time Frame: 1 day
Negative RF and negative ACPA (Score 0) Low-positive RF or low-positive ACPA( anticitrullinated protein antibody) (score 2) High-positive RF(rheumatoid factor) or high-positive ACPA (score 3)
D.Duration of symptoms
Time Frame: 1 day
\<6 weeks (score 0) \>6 weeks (score 1)
Uromodulin measure
Time Frame: 1 day
First urine sample taken in the morning
Secondary Outcomes
- MDRD (Modification of Diet in Renal Disease)(1 day)
- Sedimantation measure(1 day)
- Urea measure(1 day)
- CKD-EPI (Chronic Kidney Disease Epidemiology Colloboration)(1 day)
- Creatinine measure(1 day)
- pH measure(1 day)
- Microalbuminuria measure(1 day)
Investigators
neval aksoy
Medical Doctor, Head of Urine Laboratory Department
Istanbul Saglik Bilimleri University