Evaluation of the relationship between serum adhesion molecules (ICAM-1, VCAM-1, E-SELECTIN, PECAM-1) levels and morning stiffness, hand functions in patients with rheumatoid arthritis

Introduction and Objective: Rheumatoid arthritis (RA) is an autoimmune disease primarily characterized by joint involvement and leading to destruction of diarthrodial synovial joints. Morning stiffness, impaired hand function, and deformities significantly restrict patients' daily lives. Although cell adhesion molecules (CAMs) play critical roles in RA pathophysiology, their relationship with RA symptoms and disease activity has not been fully elucidated. In this study, we investigated the serum levels of E-selectin, Intercellular Adhesion Molecule-1 (ICAM-1), Vascular Cell Adhesion Molecule-1 (VCAM-1), and Platelet Endothelial Cell Adhesion Molecule-1 (PECAM-1) in patients diagnosed with RA, examining their association with morning stiffness and hand function. We aimed elucidate the factors influencing the clinical course of RA and to provide insights that could guide RA treatment. Material and Method: Our study included 80 patients classified with RA according to the 2010 ACR/EULAR criteria and 60 healthy controls. Morning stiffness duration and severity, Visual Analog Scale (VAS) pain score, Health Assessment Questionnaire (HAQ), Short Form-36 (SF-36), ABILHAND-RA Hand Function Questionnaire, and Modified Sharp Heijde Scores were measured. The relationships between serum CAM levels and these clinical parameters were analyzed. Results: We found that the levels of CAMs were significantly higher in RA patients compared to the control group. While an inverse relationship was observed between disease activity and VCAM-1 levels, no significant association was found between other CAM levels and disease activity. Furthermore, there was no significant relationship between CAM levels and morning stiffness duration and severity, hand function, or the extent of joint damage as assessed by Modified Sharp Heijde Scores. Discussion and Conclusion: Our study demonstrated that CAM levels are elevated in RA patients compared to controls. However, CAM levels did not show a significant association with morning stiffness duration and severity, hand function, or joint damage severity. Further research with larger cohorts and the measurement of different molecule levels is needed to elucidate the factors influencing morning stiffness, hand functions, disease activity and joint damage in RA patients. KEYWORDS: Rheumatoid Arthritis, cell adhesion molecules, morning stiffness, hand functions, The Modified Sharp/Heijde Score