Mediators of Inflammation

Mediators of Inflammation / 2015 / Article

Evaluation of Serum Amyloid A as a Marker of Persistent Inflammation in Patients with Rheumatoid Arthritis

  • Mehmet Agilli | Fevzi Nuri Aydin | ... | Yasemin Gulcan Kurt |
  •  Article ID 843152 |
  •  Published 28 Jan 2015

Response to: Comment on “Serum Amyloid A as a Marker of Persistent Inflammation and an Indicator of Cardiovascular and Renal Involvement in Patients with Rheumatoid Arthritis”

  • Bożena Targońska-Stępniak | Maria Majdan |
  •  Article ID 749565 |
  •  Published 23 Feb 2015
  • | View Article

Letter to the Editor | Open Access

Volume 2015 |Article ID 843152 | https://doi.org/10.1155/2015/843152

Mehmet Agilli, Fevzi Nuri Aydin, Tuncer Cayci, Yasemin Gulcan Kurt, "Evaluation of Serum Amyloid A as a Marker of Persistent Inflammation in Patients with Rheumatoid Arthritis", Mediators of Inflammation, vol. 2015, Article ID 843152, 2 pages, 2015. https://doi.org/10.1155/2015/843152

Evaluation of Serum Amyloid A as a Marker of Persistent Inflammation in Patients with Rheumatoid Arthritis

Academic Editor: Eeva Moilanen
Received24 Dec 2014
Accepted18 Jan 2015
Published28 Jan 2015

We read with great interest the paper by Targońska-Stępniak and Majdan titled “Serum Amyloid A as a Marker of Persistent Inflammation and an Indicator of Cardiovascular and Renal Involvement in Patients with Rheumatoid Arthritis” in which the investigators reported that high serum amyloid A (SAA) concentration was strongly associated with activity of the disease and risk of cardiovascular and renal involvement in patients with rheumatoid arthritis [1]. We thank the authors for their detailed report. However, we wish to make some comments on SAA.

SAA is produced in the liver in response to proinflammatory cytokines such as tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), and IL-6 [2]. Previous studies suggested that several diseases such as ankylosing spondylitis, autoinflammatory diseases (Hashimoto’s thyroiditis, familial Mediterranean fever), major depression, systemic lupus erythematosus, diabetes mellitus, inflammatory bowel diseases, acute pancreatitis, several types of vasculitis, psoriasis, and epilepsy could affect SAA levels [3, 4]. In addition to these diseases, glucocorticoids, statins, disease-modifying antirheumatic drugs, corticosteroids, and nonsteroidal anti-inflammatory drugs could alter SAA levels [5, 6]. Also, dietary food supplements such as antioxidants (ascorbic acid, taurine, and phytic acid), vitamin E, vitamin A, α linoleic acid, omega-3 fatty acids, and polyunsaturated fatty acids can influence SAA levels [7, 8]. In this respect, without defining these contributing factors, interpreting the results is problematic.

Alcohol use and smoking status of participants are other confounding factors for SAA measurement [9, 10]. Therefore, these factors have to be expressed and a multivariate regression analysis should be applied to show whether these variables have an impact on SAA levels.

In conclusion, clarifying these concerns will certainly provide a clearer picture when interpreting SAA levels among participants.

Conflict of Interests

The authors declare no conflict of interests.

References

  1. B. Targońska-Stępniak and M. Majdan, “Serum amyloid A as a marker of persistent inflammation and an indicator of cardiovascular and renal involvement in patients with rheumatoid arthritis,” Mediators of Inflammation, vol. 2014, Article ID 793628, 7 pages, 2014. View at: Publisher Site | Google Scholar
  2. J. C. H. van der Hilst, “Recent insights into the pathogenesis of type AA amyloidosis,” TheScientificWorldJournal, vol. 11, pp. 641–650, 2011. View at: Publisher Site | Google Scholar
  3. L. Obici, S. Raimondi, F. Lavatelli, V. Bellotti, and G. Merlini, “Susceptibility to AA amyloidosis in rheumatic diseases: a critical overview,” Arthritis Care & Research, vol. 61, no. 10, pp. 1435–1440, 2009. View at: Publisher Site | Google Scholar
  4. G. Li, F. Ren, J. Yao, M. Wang, X. Feng, and D. Liu, “Human serum amyloid A (SAA) protein changes in acute epilepsy patients,” International Journal of Neuroscience, vol. 123, no. 4, pp. 265–268, 2013. View at: Publisher Site | Google Scholar
  5. T. Fushimi, Y. Takahashi, Y. Kashima et al., “Severe protein losing enteropathy with intractable diarrhea due to systemic AA amyloidosis, successfully treated with corticosteroid and octreotide,” Amyloid, vol. 12, no. 1, pp. 48–53, 2005. View at: Publisher Site | Google Scholar
  6. Y. Horiuchi, S. Hirayama, S. Soda et al., “Statin therapy reduces inflammatory markers in hypercholesterolemic patients with high baseline levels,” Journal of Atherosclerosis and Thrombosis, vol. 17, no. 7, pp. 722–729, 2010. View at: Publisher Site | Google Scholar
  7. D. Giugliano, A. Ceriello, and K. Esposito, “The effects of diet on inflammation: emphasis on the metabolic syndrome,” Journal of the American College of Cardiology, vol. 48, no. 4, pp. 677–685, 2006. View at: Publisher Site | Google Scholar
  8. A. Spreafico, L. Millucci, L. Ghezzi et al., “Antioxidants inhibit SAA formation and pro-inflammatory cytokine release in a human cell model of alkaptonuria,” Rheumatology (United Kingdom), vol. 52, no. 9, pp. 1667–1673, 2013. View at: Publisher Site | Google Scholar
  9. B. S. Pruett and S. B. Pruett, “An explanation for the paradoxical induction and suppression of an acute phase response by ethanol,” Alcohol, vol. 39, no. 2, pp. 105–110, 2006. View at: Publisher Site | Google Scholar
  10. A. I. Al-Sieni, A. I. Al-Alawy, Z. S. Al-Shehri, and F. A. Al-Abbasi, “Serum amyloid-a protein and serum rheumatoid Factor as serological surrogate markers for smoking risk factor in Saudi population,” Pakistan Journal of Pharmaceutical Sciences, vol. 26, no. 2, pp. 239–243, 2013. View at: Google Scholar

Copyright © 2015 Mehmet Agilli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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