Rheumatoid Arthritis Clinical Trial
Official title:
Uromodulin Levels in Rheumatoid Arthritis
The aim of the present study was to evaluate the levels of uromodulin in rheumatoid arthritis (RA) and to investigate whether it was correlated with baseline clinical characteristics. In addition CKD epi,MDRD,urine microalbuminuria,pH,serum urea, creatinine,CRP (C-Reactive protein) were measured.The participants consist of ; %68 patients,% 32 control group.
Uromodulin, also known as Tamm-Horsfall protein, is a protein abundantly excreted in the
urine in healthy individuals. It is synthesized in the thick ascending limb of Henle (TALH)
and the early distal convoluted tubule. Its biologic function is still obscure; however, some
experimental studies indicated that it might serve as an important urinary defense factor
against bacterial colonization and stone formation.
There are controversial publications on the frequencies of urinary tract infections and
nephrolithiasis in patients with mutations of uromodulin gene. Deposition of mutated
uromodulin in the urinary system may lead to tubular cell dysfunction and apoptosis. These
alterations may subsequently cause tubular atrophy and interstitial fibrosis . Moreover, the
release of abnormal uromodulin after apoptosis through basolateral secretion may elicit an
immune response which may give rise to an immune-mediated tubulointerstitial nephritis .
Uromodulin can activate the other components of the immune system and may modulate the
inflammatory and immune responses through different mechanisms .
Experimental studies yielded that uromodulin negative mice displayed splenomegaly with
infiltration of white pulp by macrophages and increased levels of TNF-α and interleukin-1 .
Rheumatoid arthritis is a systemic autoimmune condition that may eventually result in the
joint damage, disability and premature mortality.
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