Background Ceruloplasmin (CP) is an acute phase reactant with significant antioxidative activity. In rheumatoid arthritis (RA), joint destruction continues in spite of high levels of CP in the synovial fluid (SF). The antioxidative activity of CP correlates with its ferroxidase I activity (FerrI). The biology role of the recently discovered ferroxidase II (FerrII) is unknown.

Objectives The present study was aimed to find the effect of drug therapy on CP levels and CP ferroxidase activity in RA SF and to compare it to SF nitrite levels, which indicate the degree of the inflammatory process.

Methods SF was collected from 75 RA patients who were:

1. w/o drug therapy (UT).

2. with NSAIDs and disease modifying drugs (DMD), mainly MTX who had no steroid in the last 3 months (NST).

3. with low dose steroids (=/ < 10 mg Prednisone) + DMD ST).

4. SF of osteoarthritic (OA) patients served as control. For CP levels Ravin’s method was used.¹ For CP ferroxidase activity Johnson’s method was used.² For FerrII activity Johnson’s method in the presence of sodium azide. FerrI activity was calculated: Total-FerrII. For nitrite levels Ding’s method was used.³

Results Inspite of drug therapy and nitrite level similar to OA, CP and total ferroxidase activity remained high in all RA groups. FerrI/FerrII ratio was significantly abnrmal in RA without steroids. Low dose steroids restored FerrI/FerrII ratio to levels seen in OA.

Conclusion Low dose steroid therapy in RA did not reduce SF ceruloplasmin concentration, but restored FerrI/FerrII ratio to normal levels.

References

1. Ravin HA. J Lab Clin Med. 1961;58:161–8

2. Johnson DA, et al. Clin Chem. 1967;13:142–9

3. Ding AH, et al. J Immunol. 1998;141:2407–13