One month after TKA, anti-CCP levels were significantly reduced (P 0

One month after TKA, anti-CCP levels were significantly reduced (P 0.01) in RA patients. However, their levels were not significantly different between pre-surgery and 1 year post-surgery (P 0.05). Furthermore, anti-CCP levels in ST were much higher than in serum. These findings suggest that RA patients should continue antirheumatic therapy after TKA. ST is the preferred place for the synthesis of anti-CCP Ab. values less than 0.05 were considered statistically significant. Results Histological analysis Histological examination revealed signs of synovitis. Synovial hyperemia and edema were seen (Figure 1) in RA patients. There were a large number of inflammatory cells especially lymphocytes in the knee of RA group. While mild synovial thickening and only few inflammatory cells were found in OA group. Open in a separate window Figure 1 HE staining of arthritic synovial tissue. Sections of RA (left) and OA (right) synovial tissue were probed with anti-CCP antibodies. Original magnification 100. Anti-CCP levels Patients were followed up for 1 year after TKA. Baseline anti-CCP levels in sera ranged from 180 to 235 U/ml (mean SD: 200 15 U/ml; n = 23) for the RA group and from 1 to 7 U/ml (mean SD: 4 2 U/ml; n = 10) for the Rabbit Polyclonal to Smad1 (phospho-Ser465) OA group. One week after surgery, anti-CCP levels began to reduce. As seen from Table 1, their postsurgical levels at one EX 527 (Selisistat) month were sharply decreased to nearly 125 U/ml. However, their levels were not significantly different between baseline and one-year post surgery for RA group (P 0.05). For OA group, anti-CCP levels did not differ before or after TKA. Considering these change, we observed anti-CCP distribution in ST and SA of RA patients. We wonder whether their levels would change with disease activity. However, from Table 2, we did not observe a decrease of anti-CCP in RA patients with inactive disease. Table 2 Anti-CCP levels in ST and SF of RA patients thead th align=”left” rowspan=”1″ colspan=”1″ /th th colspan=”2″ align=”center” rowspan=”1″ RA /th th rowspan=”3″ align=”center” valign=”middle” colspan=”1″ OA /th th rowspan=”3″ align=”center” valign=”middle” colspan=”1″ P /th th align=”left” rowspan=”1″ colspan=”1″ /th th colspan=”2″ align=”center” rowspan=”1″ hr / /th th align=”left” rowspan=”1″ colspan=”1″ (U/ml) /th th align=”center” rowspan=”1″ colspan=”1″ Active disease /th th align=”center” rowspan=”1″ colspan=”1″ Inactive disease /th /thead ST239 15235 94 1 0.05SF230 15232 114 1 0.05Serum (pre-surgery)225 16215 134 1 0.05 Open in a separate window ST: synovial tissue; SF: synovial fluid. Data from RA and OA group were compared. VAS pain reduction and knee function The average VAS value for RA group prior to surgery was comparable with that of OA group (4.5 0.9 and 4.5 0.3, respectively; not significant) (Table 3). Pain reduction (VAS values) was statistically significant for both RA and OA groups with respect to preoperative level one month after TKA (P 0.05), although it seemed more evident in OA patients. Table 3 VAS score and ROM before and after TKA thead th align=”left” rowspan=”1″ colspan=”1″ /th th colspan=”2″ align=”center” rowspan=”1″ RA /th th rowspan=”3″ align=”center” valign=”middle” colspan=”1″ OA /th th rowspan=”3″ align=”center” valign=”middle” colspan=”1″ P /th th align=”left” rowspan=”1″ colspan=”1″ /th th colspan=”2″ align=”center” rowspan=”1″ hr / /th th align=”left” rowspan=”1″ EX 527 (Selisistat) colspan=”1″ /th th align=”center” rowspan=”1″ colspan=”1″ Active disease (N = 13) /th th align=”center” rowspan=”1″ colspan=”1″ Inactive disease (N = 10) /th /thead VAS????pre-surgery4.5 0.93.8 0.84.5 0.3 0.05????1 month post-surgery2.8 0.82.5 0.62.1 0.3 0.05ROM????pre-surgery65 755 562 5 0.05????1 month post-surgery85 988 591 7 0.01HSS????pre-surgery51.3 10.652.1 9.854.7 12.5 0.05????1 month post-surgery69.8 5.372.1 4.873.1 6.4 0.05 Open in a separate window VAS: visual analogue scale; ROM: range of motion Data from pre-surgery and post-surgery were compared. Knee activity was significantly increased after TKA, with approximately 30 %30 % increase from baseline in RA group, especially in active RA patients (P 0.05). Throughout the EX 527 (Selisistat) study, patients in OA group showed higher ROM values in comparison with those in RA group, especially at 12 months after TKA (data not shown). Discussion The pathological changes in.