Erythrocyte aggregation in rheumatoid arthritis: cell and plasma factor’s role

LUQUITA, A.; URLI, L.; SVETAZ, M.J.; GENNARO, A.M.; VOLPINTESTA, R.; PALATNIK, S; RASIA, M.

Clinical Hemorheology And Microcirculation

IOS Press

Año: 2009 vol. 41 p. 49 - 56

1386-0291

Abstract. Increase in erythrocyte aggregation (EA) is pathognomonic for rheumatoid arthritis (RA), and its estimation througherythrocyte sedimentation rate (ESR) is part of DAS 28-4 activity diagnosis, with low correlation with EA and that does notdiscriminate the contribution of cell factors that increase aggregation.Objective: To analyse cell and plasma factors that might be involved in EA increase, to understand how RA affects bloodcomponents, thus modifying blood fluid behavior.Methodology: One hundred women presenting active RA were compared with age-matched controls (C). EA was measuredby transmitted light, obtaining two parameters: 2k2n0, characterizing the aggregation process kinetics and s0/n0, estimatingaggregates size. Cell factors assays: erythrocyte deformability, by filtration through nucleopore membranes, cell shape, bymicroscopy, and membrane fluidity by EPR. Plasma: total proteins and CRP, albumin, fibrinogen (Fb), by gravimetry, and IgGand IgM by single radial immuno-diffusion.Results: AR and C (x ± SE). 2k2n0: 31.83 ± 2.84, 23.75 ± 1.91; s0/n0: 0.92 ± 0.05, 0.87 ± 0.04. Rigidity index (RI): 14.79 ± 4.71, 6.92 ± 1.31. Morphological index: 0.28 ± 0.03, 0.30 ± 0.05, n.s. Fb (mg/dl): 382 ± 80, 299 ± 70. IgG (mg/dl): 1580 ± 219, 1296 ± 158; IgM (mg/dl) 233 ± 28, 183 ± 23; albumin (g/dl) 3.84 ± 0.44, 3.77 ± 0.51 n.s. p < 0.05 accepted.Correlations: 2k2n0 vs. Fb r = 0.66; s0/n0 vs. Fb r = 0.51; 2k2n0 vs. Igs r = 0.65; s0/n0 vs. Igs r = 0.56. 2k2n0 vs. RI r = −0.59; s0/n0 vs. RI = −0.52, p < 0.05.Conclusions: Plasma factors, Igs and Fb increased aggregation, since RI is altered, this reduces the process efficiency regardingaggregation. Patients with active RA present an increased EA, with values modifications associated with the activity indexDAS 28-4, thus becoming an RA activity indicator.