Correlation of level of expression of Wnt Signaling Pathway Inhibitor Dickkopf-1 with disease activity in Elderly patients of Rheumatoid Arthritis: A cross sectional study
Objective: To correlate the level of Dickkopf-1 (DKK-1) and its role in rheumatoid arthritis (RA) patients of elderly age group.
Methods: Serum samples were collected elderly RA patients fulfilling the inclusion criteria coming to Geriatric outdoor clinic between June 2018 to September 2018. DKK-1 was detected by ELISA. Serum C-reactive protein (CRP) levels, erythrocyte sedimentation rates (ESR), rheumatoid factor (RF) titers, and anti-cyclic citrullinated peptide antibody were also measured in patients with RA.
Results: Twenty one patients were enrolled in study period. The serum level of DKK-1 was significantly higher in patients with severe RA with high DAS score (p < 0.01); The serum DKK-1 level was correlated with T-score (r= -0.588; p = 0.005), Z-Score(r= -0.458, p = 0.037) and the larson score of radiologic change (r = +0.673, p = 0.001) in RA, however not correlated significantly with ESR, CRP.
Conclusion: DKK-1 may serve as a biomarker of bone erosion and correlates with the disease activity in RA patients of elderly age group.
Keyword: DKK 1, Rheumatoid arthritis, Geriatric, Osteoporosis.
2. Tian E, Zhan F, Walker R, Rasmussen E, Ma Y, Barlogie B, et al. The role of the wnt-signaling antagonist dkk1 in the development of osteolytic lesions in multiple myeloma. N Engl J Med 2003; 349:2483-94.
3. Mao B, Wu W, Li Y, Hoppe D, Stannek P, Glinka A, et al. Ldl-receptor-related protein 6 is a receptor for dickkopf proteins. Nature 2001; 411:321-5.
4. Fujita K, Janz S. Attenuation of wnt signaling by dkk-1 and -2 regulates bmp2-induced osteoblast differentiation and expression of opg, rankl and m-csf. Mol Cancer 2007; 6:71.
5. Yang L, Soonpaa MH, Adler ED, Roepke TK, Kattman SJ, Kennedy M, et al. Human cardiovascular progenitor cells develop from a kdr+ embryonic stem cell derived population. Nature 2008; 453:524-6.
6. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films Acta Radiol Diagn (Stockh) 1977; 18:481–91.
7. Gough A K, Lilley J, Eyre S, Holder R L, Emery P. Generalised bone loss in patients with early rheumatoid arthritis. Lancet 1994; 344:23–7.
8. Prevoo MLL, Hof van’t MA, Kuper HH, Leeuwen van MA, Putte van de LBA, Riel van PLCM. 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 1995; 38:44–8.
9. Pincus T, Summey JA, Soraci Jr SA, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum 1983; 26(11):1346–53.
10. Diarra D, Stolina M, Polzer K, Zwerina J, Ominsky MS, Dwyer D, et al. Dickkopf-1 is a master regulator of joint remodeling. Nat Med 2007; 13:156-63.
11. Wang SY, Liu YY, Ye H, Guo JP, Li R, Liu X, Li ZG. Circulating Dickkopf-1 is correlated with bone erosion and inflammation in rheumatoid arthritis. J Rheumatol.2011; 38(5):821-7.
12. Bloxham E, Vagadia V, Scott K, Francis G, Saravanan V, Heycock C et al. Anaemia in rheumatoid arthritis: can we afford to ignore it? Postgrad Med J. 2011; 1031:569-600.
13. Ganna S The prevalence of anemia in rheumatoid arthritis. Rev. Bras. Reumatol. 2014; 54(4):257-259.
14. Raphaèle Seror, Saida Boudaoud, Stephan Pavy, Gaetane Nocturne, Thierry Schaeverbeke, Alain Saraux, et al. Increased Dickkopf-1 in Recent-onset Rheumatoid Arthritis is a New Biomarker of Structural Severity. Scientific Reports, 2016; 6:18421.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeÂ The Effect of Open Access).