الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronically inflamed synovial joints and subsequent destruction of the cartilage and bones. Myeloperoxidase (MPO) is a heme-containing protein synthesized during myeloid differentiation and is often released from stimulated polymorphonuclear leukocytes at sites of inflammation. MPO-mediated oxidation has been described in a variety of inflammatory diseases. In the present study, we evaluated the plasma and synovial MPO levels in patients with RA, and investigated their correlation with disease activity.
This case-control study was carried out at the Physical Medicine, Rheumatology and Rehabilitation department at Suez Canal University Hospital and Ismailia General Hospital. The study included eligible 33 RA patients and 33 healthy controls. Both groups underwent complete medical history interview, thorough physical examination, and blood sampling (for plasma MPO level, ESR, CRP … etc.). Further, RA patients underwent synovial fluid sampling for synovial MPO.
Study results showed that the plasma MPO level in RA patients was significantly higher than their controls (Mean: 6.15 vs. 3.41 ng/mL). Elevated synovial MPO level was detected in RA patients, with a mean of 4.58 ng/mL (±2.03). Both plasma and synovial MPO shows significant positive correlations with the duration of disease, VAS, the number of tender and swollen joints, ESR level and disease activity score (DAS-28). For every unit increase in the disease activity score, the plasma MPO level increases by 27%, while every unit increase in the disease activity score was associated with 63% increase in the synovial MPO level. Both plasma and synovial MPO show significantly large area under the curve (AUC) (0.688 and 0.952, respectively), denoting a high.