SERUM HYALURONATE IN RHEUMATOID ARTHRITIS: STUDY BY AFFINO-IMMUNOENZYMATIC ASSAY

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Abstract
Serum level of hyaluronate (HA) was assayed by an affino-immunoenzymatic method using hyaluronectin, in 25 patients with rheumatoid arthritis (RA), 24 patients with ankylosing spondylitis (AS) and 103 controls. The mean serum HA level was significantly higher (p < 0.001) in RA (171 ± 39µg/1) than in controls (22.4 ± 1.6µg/1) and AS patients (30.3 ± 3.0µg/1). The mean HA level in RA on corticosteroids (98.2 ± 25.9µg/1) was significantly lower (p < 0.05) than that of RA without steroids (220.1 ± 60.5µg/1). The serum HA levels were not correlated with clinical or serological indicators of inflammatory activity. This increase in serum HA probably reflected an excessive production by rheumatoid synovium and not a lowered catabolism, all patients having normal hepatic function. The origin of the increased synthesis is still unknown. These results suggest that serum hyaluronate is not a universal indicator of inflammation but is perhaps a characteristic of RA.