Abstract
A number of mediators are involved in the inflammatory processes that affect joints and vascular wall of patients with rheumatoid arthritis (RA). Tumour necrosis factor alpha (TNFa) is one such mediator, and it is widely regarded as an important target for anti-rheumatic treatment. Most recent studies show that anti-TNFa medication suppresses inflammation and reduces overall activity of RA. The aim of the current study was to investigate changes of mean platelet volume (MPV) in response to the 3-month anti-TNFa therapy in RA. Twenty-one RA patients without established cardiovascular disease were recruited for anti-TNFa therapy and underwent thorough clinical and laboratory evaluation at baseline, 2 weeks, and 12 weeks. Anti-TNFa therapy resulted in a significant (p = 0.01) increase in MPV over the duration of the study (7.7 ± 0.9, 7.8 ± 1.1, and 8.4 ± 1.1 fL at baseline, 2 weeks, and 12 weeks, respectively). The results of the study expand perspectives of the use of MPV in conditions associated with high-grade inflammation, particularly RA, for monitoring anti-inflammatory treatment. More prospective studies with large numbers of patients are warranted to ascertain associations of high and low values of MPV with diverse markers of inflammation and vascular pathology.
References
Kitas GD, Erb N (2003) Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology (Oxford) 42:607–613
Douglas KM, Pace AV, Treharne GJ, Saratzis A, Nightingale P, Erb N, Banks MJ, Kitas GD (2006) Excess recurrent cardiac events in rheumatoid arthritis patients with acute coronary syndrome. Ann Rheum Dis 65:348–353
Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52:722–732
Panoulas VF, Metsios GS, Pace AV, John H, Treharne GJ, Banks MJ, Kitas GD (2008) Hypertension in rheumatoid arthritis. Rheumatology 47:1286–1298
Toms TE, Symmons DP, Kitas GD (2010) Dyslipidaemia in rheumatoid arthritis: the role of inflammation, drugs, lifestyle and genetic factors. Curr Vasc Pharmacol, 1 Jan 2010 [Epub ahead of print]
Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF, Douglas KM, Nevill AM, Jamurtas AZ, Kita M, Koutedakis Y, Kitas GD (2009) Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis. Ann Rheum Dis 68:242–245
Metsios GS, Stavropoulos-Kalinoglou A, Veldhuijzen van Zanten JJ, Treharne GJ, Panoulas VF, Douglas KM, Koutedakis Y, Kitas GD (2008) Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review. Rheumatology (Oxford) 47:239–248
Bacon PA, Stevens RJ, Carruthers DM, Young SP, Kitas GD (2002) Accelerated atherogenesis in autoimmune rheumatic diseases. Autoimmun Rev 1:338–347
Emery P, Gabay C, Kraan M, Gomez-Reino J (2007) Evidence-based review of biologic markers as indicators of disease progression and remission in rheumatoid arthritis. Rheumatol Int 27:793–806
Hürlimann D, Forster A, Noll G, Enseleit F, Chenevard R, Distler O, Béchir M, Spieker LE, Neidhart M, Michel BA, Gay RE, Lüscher TF, Gay S, Ruschitzka F (2002) Anti-tumor necrosis factor-alpha treatment improves endothelial function in patients with rheumatoid arthritis. Circulation 106:2184–2187
Wolfe F, Michaud K (2004) Heart failure in rheumatoid arthritis: rates, predictors, and the effect of anti-tumor necrosis factor therapy. Am J Med 116:305–311
Chung I, Choudhury A, Lip GY (2007) Platelet activation in acute, decompensated congestive heart failure. Thromb Res 120:709–713
Ingegnoli F, Fantini F, Favalli EG, Soldi A, Griffini S, Galbiati V, Meroni PL, Cugno M (2008) Inflammatory and prothrombotic biomarkers in patients with rheumatoid arthritis: effects of tumor necrosis factor-alpha blockade. J Autoimmun 31:175–179
Arvidson NG, Larsen A, Aaseth J, Larsson A (2007) Short-term effects of the TNFalpha antagonist infliximab on the acute phase reaction and activities of daily life in patients with rheumatoid arthritis. Scand J Clin Lab Invest 67:337–342
Gonzalez-Gay MA, Garcia-Unzueta MT, Gonzalez-Juanatey C, Miranda-Filloy JA, Vazquez-Rodriguez TR, De Matias JM, Martin J, Dessein PH, Llorca J (2008) Anti-TNF-alpha therapy modulates resistin in patients with rheumatoid arthritis. Clin Exp Rheumatol 26:311–316
Milovanovic M, Nilsson E, Järemo P (2004) Relationships between platelets and inflammatory markers in rheumatoid arthritis. Clin Chim Acta 343:237–240
Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, Kiraz S, Ertenli I, Calguneri M (2008) Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 75:291–294
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
National Institute of Clinical Excellence (2007) Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis. http://www.nice.org.uk/nicemedia/pdf/TA130guidance.pdf
Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48
Dastjerdi MS, Emami T, Najafian A, Amini M (2006) Mean platelet volume measurement, EDTA or citrate? Hematology 11:317–319
Caporali R, Pallavicini FB, Filippini M, Gorla R, Marchesoni A, Favalli EG, Sarzi-Puttini P, Atzeni F, Montecucco C (2009) Treatment of rheumatoid arthritis with anti-TNF-alpha agents: a reappraisal. Autoimmun Rev 8:274–280
Gonzalez-Gay MA, Gonzalez-Juanatey C, Miranda-Filloy JA, Garcia-Porrua C, Llorca J, Martin J (2006) Cardiovascular disease in rheumatoid arthritis. Biomed Pharmacother 60:673–677
Buttarello M, Plebani M (2008) Automated blood cell counts: state of the art. Am J Clin Pathol 130:104–116
Bath PM, Butterworth RJ (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 7:157–161
Bath P, Algert C, Chapman N (2004) Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 35:622–626
Yilmaz MB, Cihan G, Guray Y, Guray U, Kisacik HL, Sasmaz H, Korkmaz S (2008) Role of mean platelet volume in triagging acute coronary syndromes. J Thromb Thrombolysis 26:49–54
Papanas N, Symeonidis G, Maltezos E, Mavridis G, Karavageli E, Vosnakidis T, Lakasas G (2004) Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 15:475–478
Boos CJ, Beevers GD, Lip GY (2007) Assessment of platelet activation indices using the ADVIATM 120 amongst ‘high-risk’ patients with hypertension. Ann Med 39:72–78
Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A (2007) Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 120:245–250
Coban E, Afacan B (2008) The effect of rosuvastatin treatment on the mean platelet volume in patients with uncontrolled primary dyslipidemia with hypolipidemic diet treatment. Platelets 19:111–114
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Gasparyan, A.Y., Sandoo, A., Stavropoulos-Kalinoglou, A. et al. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 30, 1125–1129 (2010). https://doi.org/10.1007/s00296-009-1345-1
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DOI: https://doi.org/10.1007/s00296-009-1345-1