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© 1990 British Society for Rheumatology

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PLASMA LACTOFERRIN AND NEUTROPHIL ELASTASE IN RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS

E. O. ADEYEMI, L. B. CAMPOS, S. LOIZOU, M. J. WALPORT and H. J. F. HODGSON

Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital 150 Du Cane Road, London W120HS

Correspondence to: Correspondence to: Dr E. Adeyemi, Gastroenterology Unit, Hammersmith Hospital, London W12 0HS.

In order to assess lactoferrin (LF), stored in specific granules of neutrophils, as a marker of inflammation, LF was measured in plasma and serum samples of patients with active rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). In active RA, the median plasma LF level (800 ng/ml) was significantly higher than in normal individuals (220 ng/ml) (P <0.000 01) and patients with active SLE (235 ng/ml) (P <0.000 01). Median plasma elastase-proteinase inhibitor complex (EPIC) and C-reactive protein (CRP) levels were also significantly higher in patients with RA than in normal individuals (P <0.000 01) and active SLE (P <0.000 01 for both EPIC and CRP). Elevations of LF, EPIC and CRP in RA were independent of rheumatoid factor titres. Plasma lactoferrin in RA correlated significantly with EPIC (Rs = 0.7, P <0.0001), CRP (Rs = 0.72, P <0.0001) and absolute neutrophil counts (Rs = 0.483, P <0.02), but surprisingly not with the Ritchie index, with which CRP showed a weak but significant correlation (Rs = 0.27, P<0.05>0.025). Thus plasma LF and EPIC are markers of inflammation in RA and their levels may reflect release of mediators of inflammation into the joint space and periarticular tissue.

KEY WORDS: Inflammation, Elastase-proteinase inhibitor complex, C-reactive protein, Disease activity


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