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. 2020 Nov;48(11):300060520962954.
doi: 10.1177/0300060520962954.

Elevated serum granzyme B levels are associated with disease activity and joint damage in patients with rheumatoid arthritis

Junjie Qiao  1 , Meng Zhou  2 , Zheng Li  3 , Jie Ren  3 , Guanghan Gao  3 , Jumei Zhen  1 , Guanglei Cao  3 , Lixiang Ding  1
Affiliations

Elevated serum granzyme B levels are associated with disease activity and joint damage in patients with rheumatoid arthritis

Junjie Qiao et al. J Int Med Res. 2020 Nov.

Abstract

Objectives: Little is known about the roles of granzyme B in rheumatoid arthritis (RA). We aimed to evaluate the serum level of granzyme B in patients with RA and determine relationships with clinical features and joint destruction of RA.

Methods: We enrolled 100 patients with RA, 50 patients with osteoarthritis (OA), and 50 healthy controls (HC). Granzyme B serum concentrations were measured by ELISA; we then analyzed associations between granzyme B levels, clinical features, and joint destruction by calculating Sharp scores and disease activity as measured by Disease Activity Score-28 based on erythrocyte sedimentation rate (DAS28-ESR) in patients with RA.

Results: Compared with HC and patients with OA, serum granzyme B levels in patients with RA were remarkably elevated. Serum granzyme B levels did not differ between patients with OA and HC. Granzyme B levels correlated with ESR, rheumatoid factor, swollen joint counts, joint erosion scores, total Sharp scores, and DAS28-ESR. Moreover, patients with RA with high disease activity had higher granzyme B levels.

Conclusions: Serum granzyme B levels were elevated significantly in patients with RA and correlated positively with disease activity and joint destruction. Serum granzyme B may have potential applications in laboratory evaluation of patients with RA.

Keywords: DAS28; Rheumatoid arthritis; Sharp score; disease activity; granzyme B; joint destruction.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Comparison of serum granzyme B levels in patients with RA and OA, and HC. Concentrations of granzyme B were substantially increased in patients with RA compared with patients with OA and HC, but there was no difference between patients with OA and HC (a). No difference was found between female and male patients with RA (b). No correlation was found between granzyme B levels and duration of disease (c) or age (d) of patients with RA. Error bars indicate SD; ***P < 0.001, ns, nonsignificant RA, rheumatoid arthritis; OA, osteoarthritis; HC, healthy controls.
Figure 2.
Figure 2.
Associations between the levels of granzyme B and clinical characteristics of patients with RA. Serum granzyme B levels were positively correlated with ESR (a), RF (b), and SJC (c) RA, rheumatoid arthritis; ESR, erythrocyte sedimentation rate; RF, rheumatoid factor; SJC, swollen joint counts.
Figure 3.
Figure 3.
Correlations between granzyme B levels and joint damage of patients with RA. Serum granzyme B levels was positively correlated with total Sharp score (a) and joint erosion score (b), but not with joint space narrowing score (c). RA, rheumatoid arthritis.
Figure 4.
Figure 4.
Correlation analysis of serum granzyme B levels with patients with RA disease activity. Serum granzyme B concentrations were positively correlated with DAS28-ESR in patients with RA (a). A significant difference in granzyme B level was found between the low/moderate disease activity group (DAS28-ESR ≤5.1) and the high disease activity group (DAS28-ESR >5.1) (b). Error bars indicate SD; *P < 0.05 RA, rheumatoid arthritis; DAS28-ESR, Disease Activity Score 28-joint count based on erythrocyte sedimentation rate.
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