Comparison of biomarkers and immunological parameters between hemophilia patients, rheumatoid arthritis patients, and control subjects

R. Toenges1, A. Wittenbrinck1, S. Gundermann1, M. Wahle2, R. Schäfer1, W. Miesbach1 (1Frankfurt am Main, Germany, 2Augsburg, Germany)

Bleeding disorders, coagulation and fibrinolytic factors
Date: 17.02.2017,
Time: 17:15 - 18:15

Objective: Patients with haemophilia or rheumatoid arthritis (RA) may develop severe joint damage caused by recurrent joint bleeds in haemophilia and by chronic inflammation in RA, respectively. Similarities in clinical presentation and medical imaging have also been shown. Biomarkers are useful diagnostic tools to assess joint damage in RA. However, to date only limited data are available for biomarkers in haemophilia arthropathy.

Methods: A panel of biomarkers was assessed in 129 men older than 30 years (40 haemophilia patients without arthropathy, 23 haemophilia patients with arthrophathy, 23 patients with RA and 43 control subjects). The median age was 49.1 years for the haemophilia patients, 62.9 years for the RA patients, and 46.7 years for the control group, respectively. During follow-up examination 61 different biomarkers were analyzed including immunological, inflammation, coagulation, angiogenesis-related parameters and cytokines. Arthropathy was characterized by painfull swelling, loss of function, typical radiology images and surgical treatment of joints. The RA patients were classified according to ACR/EULAR criteria.

Results: We identified 24 parameters of angiogenesis and cytokines with significant differences between haemophilia patients, RA patients, and healthy individuals. Most of them (20) were reduced (e.g. VEGFR1 or TNF-alpha) whereas only EGFR, osteopontin, IL6-RA and IL-7 were elevated. Both groups of patients had a significant increase of the acute phase protein ferritin, the angiogenesis parameter HGF and the cytokine MIP-1b. Similar reaction patterns were observed for alpha2-macroglobulin, follistatin, leptin, PECAM-1, IL-10, and VEGFR-2.

Conclusion: We assessed 61 different immunological blood parameter and biomarkers in haemophilia, RA patients, and healthy individuals. Twenty four parameters were different in haemophilia patients. In addition, significant differences could be demonstrated between haemophiliacs and RA patients compared to controls for three parameters (ferritin, HGF, and MIP-1b). Therefore, we could show a specific immunological profile for haemophilia as well as a common biomarker profile for the arthropathy in haemophilia and RA. Further research should be performed to evaluate the potential of established and new biomarkers to follow-up joint damage and chronic arthrophathy in haemophilia.