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. 2020 May 15;8(5):125.
doi: 10.3390/biomedicines8050125.

Inflammatory and Oxidative Stress Markers-Mirror Tools in Rheumatoid Arthritis

Radu Răzvan Mititelu  1 , Rodica Pădureanu  1 , Manuela Băcănoiu  2 , Vlad Pădureanu  3 , Anca Oana Docea  4 , Daniela Calina  5 , Andreea Lili Barbulescu  6 , Ana Maria Buga  1
Affiliations

Inflammatory and Oxidative Stress Markers-Mirror Tools in Rheumatoid Arthritis

Radu Răzvan Mititelu et al. Biomedicines. .

Abstract

Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease, associated with significant morbidity, mainly due to progressive damage and consequent disability. Oxidative stress is an important part of RA pathophysiology, as in autoimmune disease the interaction between immune response and endogenous/exogenous antigens subsequently induce the production of reactive oxygen species. The oxidative stress process seems to be positively strongly correlated with inflammation and accelerated joint destruction. We were asking ourselves if the oxidative stress biomarkers are the mirror tools of disease activity, outcome, and inflammation level in a group of RA patients under standard or biological therapy compared to healthy age-matched controls. In order to do this, the oxidative stress damage biomarkers (lipids peroxide and protein carbonyl level), antioxidant defense capacity, and pro-inflammatory status of plasma were quantified. In this study, we took into account the complete picture of RA diseases and assessed, for the first time, the inflammatory level in correlation with the oxidative stress level and antioxidant capacity of RA patients. Our results revealed that protein oxidation through carbonylation is significantly increased in RA groups compared to controls, and both protein carbonyl Pcarb and thiobarbituric acid reactive substance (TBARS) are reliable markers of ROS damage. Therefore, it is unanimous that neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio ( MLR), platelet/lymphocyte ratio (PltLR) correlated with Pcarb, and TBARS can provide a view of the complex phenomenon represented by proteins/lipids damage, key contributors to disease outcome, and an increased awareness should be attributed to these biomarkers.

Keywords: autoimmune diseases; biomarkers; inflammation; oxidative stress; rheumatoid arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Bar plot (mean with SEM) of the neutrophil/lymphocyte (NLR) ratio in the rheumatoid arthritis (RA) group vs. control group (** p = 0.001); (b) receiver operating characteristic (ROC) analysis of NLR in the RA group vs. control group (AUC = 0.82).
Figure 2
Figure 2
(a) Bar plot (mean with SEM) of the monocyte/lymphocyte (MLR) ratio in the RA group vs. control group (*** p = 0.0004); (b) ROC analysis of MLR in the RA group vs. control group (AUC = 0.93).
Figure 3
Figure 3
(a) Bar plot (mean with SEM) of the platelet/lymphocyte ratio (PltLR) in the RA group vs. control group (p = 0.001); (b) ROC analysis of PltLR in the RA group vs. control group (AUC = 0.70).
Figure 4
Figure 4
Bar plot (mean ± SEM) and ROC analysis of oxidative stress biomarkers in plasma, (a) protein damage marker in plasma (Pcarb) in healthy controls vs. RA group 1 (* p < 0.05) and RA group 2 (** p < 0.05); (b) lipid peroxidation marker in plasma (TBARS) in healthy controls vs. RA group 1 (* p < 0.05) and RA group 2 (* p < 0.05); (c) ROC analysis of TBARS performance in plasma; (d) the ROC analysis of Pcarb performance in plasma.
Figure 5
Figure 5
Bar plot (mean ± SEM) and ROC analysis of the total antioxidant capacity in plasma, (a) total antioxidant capacity (TAC) in healthy controls vs. RA group 1 (p < 0.05) and RA group 2 (** p < 0.05); (b) ROC analysis of TAC performance in plasma.
Figure 6
Figure 6
Association analysis of the Pcarb level with NLR (p = 0.0008, r = 0.62).
See this image and copyright information in PMC

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