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Clinical Trial
. 2021 Jun 1;11(1):11525.
doi: 10.1038/s41598-021-90973-2.

Clusterin serum levels are elevated in patients with early rheumatoid arthritis and predict disease activity and treatment response

Tereza Kropáčková  1   2 , Heřman Mann  1   2 , Olga Růžičková  1   2 , Olga Šléglová  1   2 , Lucia Vernerová  1 , Veronika Horváthová  1   3 , Michal Tomčík  1   2 , Karel Pavelka  1   2 , Jiří Vencovský  1   2 , Ladislav Šenolt  4   5
Affiliations
Clinical Trial

Clusterin serum levels are elevated in patients with early rheumatoid arthritis and predict disease activity and treatment response

Tereza Kropáčková et al. Sci Rep. .

Abstract

Clusterin (CLU) is a molecular chaperone that participates in a variety of biological processes. Recent studies indicate its possible involvement in the development of bone erosions and autoimmunity. The aim of this study was to investigate its serum concentrations in patients with early rheumatoid arthritis (RA) and to explore their potential relationship with disease activity and treatment response. Serum levels of CLU were measured in 52 patients before and 3 months after the initiation of treatment and in 52 healthy individuals. CLU levels at baseline were significantly increased in patients with early RA compared with healthy subjects (p < 0.0001). After 3 months of treatment, the levels of CLU decreased and reached concentrations comparable to those in controls. Even though there was no relationship between CLU levels and disease activity at baseline, CLU levels positively correlated with disease activity at months 3, 6 and 12 after treatment initiation. Using ROC analysis, lower CLU baseline levels predicted achieving the therapeutic target of low disease activity and remission at months 3, 6 and 12. In summary, we found increased serum concentrations of clusterin in treatment-naïve patients with early rheumatoid arthritis, and we suggest clusterin as a predictive biomarker of disease activity and treatment response.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Serum clusterin levels in patients with early rheumatoid arthritis (RA) at baseline and 3 months after the initiation of treatment (M3) and in healthy individuals (A). Comparison of changes in individual patients before and after 3 months of therapy (B). The horizontal lines represent the mean ± the SD.
Figure 2
Figure 2
Correlations between baseline clusterin levels and disease activity according to the CDAI, SDAI and DAS28 at baseline and months 3 (M3), 6 (M6) and 12 (M12) after treatment initiation.
Figure 3
Figure 3
ROC curve analysis of baseline CLU levels, DAS28, RF, anti-CCP and CRP levels for prediction of achieving low disease activity or remission after 3, 6 and 12 months of treatment according to the CDAI, SDAI and DAS28.
Figure 4
Figure 4
ROC curve analysis of baseline CLU levels, DAS28, RF, anti-CCP and CRP levels for prediction of achieving major treatment response after 6 and 12 months of treatment according to the CDAI and SDAI.
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