Objective: To determine whether elastase-alpha1-proteinase inhibitor (E-alpha1PI) complex behaves as an acute phase reactant in inflammatory arthritis.
Methods: E-alpha1PI complex was measured in the plasma of 89 patients with different rheumatic diseases and 28 healthy controls. Correlations were sought between standard indices of disease activity as patients went into remission with the use of disease modifying antirheumatic drugs (DMARD).
Results: Compared with levels in 28 healthy controls, E-alpha1PI was significantly higher in 58 patients with rheumatoid arthritis (RA), 14 with ankylosing spondylitis, and 17 with noninflammatory rheumatoid disease. No significant correlations were found between E-alpha1PI and various laboratory and clinical variables of disease activity in RA before introduction of a DMARD. There was a slight decrease in E-alpha1PI over 24 weeks of treatment as other acute phase reactants fell significantly, although this did not reach significant levels. No correlations were found between intra-individual change of E-alpha1PI and different indices of disease activity from Week 0 to Week 24.
Conclusion: E-alpha1PI complex levels, measured as an index of neutrophil activation, did not correlate with improvement in disease activity in inflammatory arthritis afforded by DMARD.