Serum PYCARD may become a new diagnostic marker for rheumatoid arthritis patients

BACKGROUND

The objective of this investigation is to analyze the levels and clinical relevance of serum PYCARD (Pyrin and CARD domain-containing protein, commonly known as ASC-apoptosis-associated speck-like protein containing a caspase activation and recruitment domain), interleukin-38 (IL-38), and interleukin-6 (IL-6) in individuals afflicted with rheumatoid arthritis (RA).

METHODS

Our study comprised 88 individuals diagnosed with RA who sought medical attention at the Affiliated Hospital of Chengde Medical University during the period spanning November 2021 to June 2023, constituting the test group. Additionally, a control group of 88 individuals who underwent health assessments at the same hospital during the aforementioned timeframe was included for comparative purposes. The study involved the assessment of IL-38, IL-6, PYCARD, anti-cyclic citrullinated peptide antibody (anti-CCP), and erythrocyte sedimentation rate (ESR) levels in both groups. The research aimed to explore the correlations and diagnostic efficacy of these markers, employing pertinent statistical analyses for comprehensive evaluation.

RESULTS

The test group had higher expression levels of PYCARD, IL-6, and IL-38 than the control group (P < 0.05). Based on the correlation analysis, there was a strong relationship between PYCARD and IL-38 (P < 0.01). The receiver operating characteristic (ROC) curve analysis revealed area under the curve (AUC) values of 0.97, 0.96, and 0.96 when using combinations of PYCARD and anti-CCP, IL-38 and anti-CCP, and IL-6 and anti-CCP for predicting RA, respectively. Importantly, all three of these pairs demonstrated superior AUC values compared to PYCARD, IL-38, IL-6, ESR, or anti-CCP used as standalone diagnostic indicators.

CONCLUSION

PYCARD, IL-6, and IL-38 exhibit promising potential as novel diagnostic markers and may constitute valuable tools for supporting the diagnosis of RA.

The reduction in blood loss with intra-articular injection of tranexamic acid in unilateral total knee arthroplasty without operative drains: a randomized controlled trial

The objective of this randomized controlled trial was to evaluate the efficacy and safety of intra-articular injections of tranexamic acid (TXA) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA) without drainage. Primary TKA was performed on a total of 80 patients (80 knees) affected to various degrees by knee osteoarthritis. The patients were randomized to receive 500 mg of TXA in 20 mL of normal saline solution (n = 40) or an equivalent volume of normal saline solution (n = 40), applied into the joint for 5 min at the end of surgery. Data on routine blood examination, blood loss and blood transfusion after TKA were compared between the two groups. The results showed no significant difference between the two groups in intra-operative blood loss (P = 0.136). The mean postoperative visible blood loss, hidden blood loss and transfusion requests were significantly different between the two groups (P < 0.05). The values of postoperative hemoglobin and hematocrit were lower in the control group compared with those in the treatment group (P < 0.05). No deep vein thrombosis was detected through Doppler ultrasound examination. Three hour postoperative D-dimer in the control group was higher than the treatment group (P = 0.02). There was no statistically significant difference between the coagulation indicators and range of motion in the two groups. We conclude that intra-articular TXA in patients undergoing unilateral TKA could significantly reduce postoperative blood loss and blood transfusion and avoid perioperative anemia-related complications without increased risk of venous thrombosis.