TISSUE-DERIVED MACROMOLECULES AND MARKERS OF INFLAMMATION IN SERUM INEARLY RHEUMATOID-ARTHRITIS - RELATIONSHIP TO DEVELOPMENT OF JOINT DESTRUCTION IN HANDS AND FEET

We have previously shown that serum concentrations of cartilage oligom eric matrix protein (COMP) are increased early in rheumatoid arthritis (RA) patients who subsequently develop advanced large-joint destructi on. A prognostic value for joint damage of serum concentrations of hya luronan (HA) is also suggested by previous studies. In contrast, serum concentrations of bone sialoprotein (BSP) have not been useful for id entifying patients with progressive large-joint destruction. In the pr esent study, we have examined the hypothesis that serum concentrations of these tissue-derived markers are of prognostic value in RA for the development of radiographically detectable joint damage in hands and feet. Serum concentrations of COMP, HA and BSP were quantified in samp les obtained from 62 patients within the first year after onset of RA and were related to the development of radiographically delectable dam age in these joints after 5 yr. Neither the serum concentrations of CO MP nor of BSP at inclusion predicted joint damage in hands and feet af ter 5 yr, and the concentration of these proteins did not change over the 5 yr period. However, the serum concentration of HA at inclusion c orrelated with the radiographic score at the 5 yr follow-up (r = 0.425 , P < 0.01), but was not a better predictor in this respect than the e rythrocyte sedimentation rate or C-reactive protein levels at inclusio n. Thus, serum concentrations of the three studied tissue-derived macr omolecules were in this study not useful for identifying patients pron e to small-joint destruction.