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.


Download data is not yet available.


1. Sweeney SE, Firestein GS. Rheumatoid arthritis: Regulation of synovial inflammation. Int J Biochem Cell Biol 2004; 36:372-8.
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.
23 Views | 20 Downloads
How to Cite
SINGH, A. (2019). 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. Journal of Drug Delivery and Therapeutics, 9(1), 348-350.