International Journal of Current Research and Review
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IJCRR - 14(2), January, 2022

Pages: 42-46

Date of Publication: 16-Jan-2022


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Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers

Author: Maryam Mohammed Jebur, Alaa Hussein J Al-qaisi, Nazar Sattar Harbi

Category: Healthcare

Abstract:Introduction: Rheumatoid Arthritis (RA) is a joint-damaging chronic inflammatory disease that affects the synovium and articular cartilage. RA is characterized by symmetric arthritis that primarily affects the tiny joints of the hands and feet. Adipokines play a role in the etiology of a variety of metabolic, vascular, and inflammatory diseases. The goal of this study is to compare the levels of inflammatory adipocytokines (chemerin and visfatin) and their ratios, as well as certain related biomarkers, in RA patients and healthy controls to see if they can help diagnose Rheumatoid Arthritis. Methods: A total of 70 (25 males and 45 females) RA patients' group with ages ranging from 45-65 years and 30 (10 males and 20 females) as the control group with ages ranging from 40-70 years old were involved in the study. All individuals had their biochemical parameters, demographic profile and serum chemerin and visfatin concentrations analyzed. Results: Our findings indicated that serum levels of Visfatin and Chemerin were significantly higher in individuals with rheumatoid arthritis than in healthy controls. Chemerin had moderate positive correlations with C-reactive protein (CRP) and total cholesterol (TC) while, it had weak negative correlation with high-density lipoprotein cholesterol (HDL). Conclusion: The variations in adipokine levels that we observed could play a role in diagnose of Rheumatoid Arthritis.

Keywords: Rheumatoid arthritis, Chemerin, Visfatin, Adipokines, C-reactive protein, High-density lipoproteins

Full Text:

INTRODUCTION

Rheumatoid arthritis (RA) is a systemic inflammatory disease affecting the joints principally. If left untreated, it is the most prevalent inflammatory disease of the joints, characterized by cartilage and bone degradation, leading to functional deterioration and disability. As a result, increasing cartilage and joint degeneration occurs, as well as impairment.1 According to data, women have a 3:1 chance of developing this condition. Any age group can be affected; however, the onset is most common between the ages of 40 and 60 .2 Rheumatoid arthritis has no recognized etiology. Clinical signs and symptoms can be caused by a mix of genetic predisposition and environmental triggers. RA is characterized by symmetric arthritis that primarily affects the tiny joints of the hands and feet. General discomfort and swelling of joints (often symmetrically), morning stiffness, and movement limitations that last more than one hour and can be eased by mild motions are all common indications and symptoms of RA.

However, RA can affect any organ, with the most prevalent symptoms being interstitial lung disease, renal amyloidosis, skin vasculitis, episcleritis, and poly-neuropathy of numerous mono-neuropathies. Better diagnostic biomarkers for the early detection of RA are always needed.3

Adipose tissue not only serves as a passive energy storage reservoir, but it also serves as an endocrine gland, producing and secreting a variety of bioactive peptides called adipokines.4Adipokines play a role in the etiology of a variety of metabolic, vascular, and inflammatory diseases.5 Adiponectin, resistin, leptin, visfatin, plasminogen activator inhibitor type 1 (PAI-1), tumor necrosis factor alpha (TNF- α), interleukin (IL)-6, and IL-8 are all adipokines .6

One of the future proteins in inflammatory biomarkers might be chemerin, a 16 kDa protein originally discovered in ovarian cancer patients' ascitic fluids and synovial exudates from rheumatoid arthritis patients' synovia as a result of the Tazarotene-induced gene 2 (Tig2).7,8 RA patients have increased levels of Chemerin and ChemR23 expression in their fibroblast-like synoviocytes (FLS) .9

Another pro-inflammatory adipokine that has the potential to help with RA diagnosis is Visfatin was first identified as a cytokine involved in early B-cell development, but it was renamed visfatin since it is mostly released by visceral fat. Visfatin is a peptide that is mostly secreted by the liver. The plasma level of visceral adipose tissue correlates with the amount of visceral fat in humans .10Visfatin levels in the blood are higher in RA, as is its expression in synovial fluids and inflamed synovium. The degree of inflammation, the severity of the disease, and joint destruction were all linked to visfatin serum and synovial fluid levels .10

This study aimed to evaluate RA patients' serum levels of chemerin and visfatin to those of healthy controls.

MATERIALS AND METHODS

Study participants: The current study was conducted in Al-Baghdad teaching hospital, during the period from October 2020 to March 2021. The present study included 70 (25 males and 45 females) RA patients from 45 to 65 years old and 30 (10 males and 20 females) healthy control group ranging from 40-70 years old. This study was approved by the Department of Chemistry, College of Science, Al-Nahrain University, Baghdad, and by the Research Ethics Committee of the Iraqi ministry of health, Iraq, with ethical clearance letter no.3122.

Exclusion criteria: History of hypertension, smoking, heart failure, diabetes mellitus, hypothyroidism, and hepatic or renal disorders, patients taking any medication, and drug used were all eliminated from the current study.

Sample collection: Patients and healthy individuals provided seven milliliters of venous blood placed into gel tubes for 15 minutes to coagulate. Serum was isolated from blood samples by centrifugation at 1840 x g for 15 minutes at room temperature. The serum was separated into aliquots and kept at -70°C until testing.

Measurement of Body Mass Index: BMI was measured by dividing weight (in Kilograms, Kg) by height squared (in meter, m) for each participant.

Biochemical analysis serum levels of chemerin, and visfatin were measured using enzyme-linked immune-sorbent assay (ELISA) provided by (MyBioSource, USA). The photometric method was used to evaluate the serum lipid profile total cholesterol (TC), triglyceride (TG) and high-density lipoprotein cholesterol (HDL) provided by (Linear, Spain). The fluorescence Immunoassay (FIA) method was used to evaluate the CRP level (ichroma, Korea).

Statistical Analysis of Parameters: Demographic and biochemical data in the present study were performed using GraphPad Prism software version 8.0.2 (San Diego, California, USA). T-test unpaired was performed to assess mean ± standard deviation (STD) and significant differences (P-value) among means of the two studied groups. Correlations between parameters in the present study were estimated with Pearson’s correlation coefficient. P ≤ 0.05 was considered statistically significant.

RESULTS

Table (1) shows the demographic data of the two studied groups (Rheumatoid arthritis and control). The results obtained from the preliminary analysis shown in table (1) indicated that there was no significant difference in BMI (P = 0.0993) between RA and control groups. There were no significant differences between RA group and the control group regarding age (P=0.5563).

Table (2) shows laboratory data from the blood analysis among the two groups. Our findings indicate there were significant differences between the RA or control groups regarding serum levels of CRP and TC and there were significantly higher in HDL (P< 0.0001) among two groups

Table (3) shows the different adipokine concentrations among the two groups. Statistical analysis revealed that serum levels of VSF were significantly higher (p< 0.0001) among two groups, as shown in figure (1). Furthermore, serum levels of Chem were significantly higher (P< 0.0001) in RA group compared to controls, as shown in figure (2).

We determined Pearson’s correlation coefficient among the different variables in the study. There were three significant correlations appeared in RA group. Chemerin had moderate positive correlations with CRP (r=0.452, P=0.031) and TC (r=0.504, P=0.014) while, it had weak negative correlation with HDLc(r=-0.245, P=0.041).

DISCUSSION

Rheumatoid arthritis has been linked in several studies to adipokines.11 The majority of prior research have focused on pre-existing atherosclerotic diseases or symptoms to narrow down their patient group. In our research, we looked at the serum levels of Visfatin and Chemerin in patients with RA to see what role adipokines have in the disease's etiology.

In the current study, the RA patients were obese (30.2 ± 3.4), the marked inflammation encountered in them CRP (30.8 ± 3.9) agreed with Jonssonetal.12 who reported that RA patients explained this finding by the increase in inflammatory cytokine production.

Adipocytokines are currently thought to play a role in the etiology of a variety of metabolic and inflammatory diseases, including rheumatoid arthritis. To examine its significance in the pathophysiology of these disorders, we urged researchers to look at the amounts of the adipocytokine in serum samples from patients with inflammatory and non-inflammatory rheumatic diseases, as well as healthy controls .13

serum levels of chemerin is significantly higher (P value<0.0001) in RA patients compared to the healthy individuals, which are similar to findings from a previous study .14

Chemerin was originally recognized in its precursor low biological active state, which was implicated in innate and adaptive immunological responses.15 Once activated, it directed dendritic cells and macrophages to wounded tissues and inflammatory locations, triggering fast defenses throughout the body. Obesity, diabetes, lipid profile components, and early vascular inflammation have all been linked to serum adipokine concentrations.16Chemerin and its receptor CMKLR1 create a complex that is engaged in immune response modulation and can play a role in the start and resolution of acute inflammation. Increased chemerin levels can promote inflammation by attracting immune system cells. Chemerin also elevated inflammatory mediator expression and production in the affected area. Increased levels of this adipokine in adipose tissue stimulate immune cell recruitment, which leads to increased expression of inflammatory mediators such as CRP, interleukine-6 (IL-6), and tumor necrosis factor alpha (TNF-α), which leads to inflammation exacerbation.17

Many substantial correlations between the measured parameters can be found in the correlation research. Chemerin had a positive correlation with total cholesterol TC (r=0.504, P=0.014) and a negative correlation with HDLc (r=-0.245, P=0.041) in the current study.

Chemerin is thought to regulate lipid metabolism enzymes by lowering cyclic adenosine monophosphate (cAMP) buildup and stimulating calcium release in adipocytes .18 These associations could be related to chemerin's multiple effects on various biological systems involved in RA disease, which grew stronger as the disease progressed. Chemerin is a protein that affects adipogenesis, angiogenesis, and inflammation 19, and its levels have been found to rise with the duration of RA. Furthermore, serum levels of this adipokine are linked to metabolic syndrome components such as higher BMI and plasma TG level.

In this study, another correlation was found between chemerin with CRP (r=0.452, P=0.031), indicating a relationship with systemic inflammation. This, in part, may be due to the fact that inflammatory cytokines released by adipose tissue stimulate the synthesis of CRP in the liver, which was observed in inflamed tissues, in RA .20

Moreover, serum levels of visfatin were significantly higher (p< 0.0001) in RA patients than in the healthy control group, which is in line with observations from previous work of ?Alkady et al 21 who found that visfatin level was significantly increased in patients with RA.

Visfatin may play a substantial role in the pathophysiology of RA, according to several observations. In certain studies, visfatin was found to be upregulated in active RA in response to proinflammatory stimuli like IL-6. 22 Synovial fluid and serum, the degree of inflammation, the severity of the disease, and joint destruction are all linked to visfatin levels .23

Despite the fact that visfatin is an adipokine, earlier research has found no link between it and obesity. Some research, however, have discovered a link between visfatin and inflammatory markers.24Visfatin was found in invasive synovial tissue in rheumatoid arthritis patients, and its levels were also elevated in synovial fibroblasts. Visfatin can activate IL6, Matrix metalloproteinase (MMP1 and MMP3), and TNF and IL6 in RA synovial fibroblasts, as well as TNF and IL6 in monocytes .25

CONCLUSION

Our findings reveal that chemerin and visfatin levels are significantly higher. Therefore, these alterations in adipokine levels may play a key role in the development of RA-related inflammation.

ACKNOWLEDGEMENT

The authors would like to acknowledge staff in Baghdad teaching hospital for their assistance in this work.

Source of Funding: No financial assistance was obtained from any sources.

Conflict of Interest: The authors declare that they have no known competing financial or personal relationships that could have appeared to influence the work reported in this paper.

Authors’ Contribution: This is a collaborative work among all authors.

Author 1: Designing, data collection, data analysis, article writing

Author 2: Data verification, article editing

Author 3: Data collection, article writing

All values are shown as mean±SD (Standard Deviation). S: p-value <0.05 (Significant),

NS: p-value <0.05 (Non-Significant),HS: p-value <0.0001 (Highly Significant).
CRP – C-reactive protein, HDLc high-density lipoprotein cholesterol, TC total cholesterol, TG – triglyceride

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A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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