14–3-3 eta (η) protein as a promising marker for rheumatoid arthritis: relation to joint damage and subclinical atherosclerosis

Abstract

Background: Accelerated atherosclerosis is a common health insult in rheumatoid arthritis (RA) patients. Pro-inflammatory cytokines, endothelial dysfunction, and autoantibodies participate in the progression of RA-related atherosclerosis. Novel biomarkers may help early detection of subclinical atherosclerosis and represent new therapeutic targets. We aimed to assess serum 14–3-3 eta (η) protein in RA patients and to explore its relation to radiological joint damage and subclinical atherosclerosis after excluding traditional risk factors for atherosclerosis. Results: The patients have increased serum 14–3-3 η protein and carotid intima-media thickness (CIMT) compared to the controls. The serum 14–3-3 η protein in our patients was positively correlated with age, disease duration, Larsen score, Rt-CIMT, Lt-CIMT, mean CIMT, C reactive protein (CRP), and Anti-citrullinated protein antibodies (ACPA). At a 31.05 ng/ml cut-off value, 14–3-3 η protein had 86.7% sensitivity and 84% specificity for RA. At a 45.7 ng/ml cut-off value, 14–3-3 η protein had 70.3% sensitivity and 79.2% specificity for the CIMT. Conclusion: 14–3-3 η protein may be a valuable prognostic marker for RA. It positively correlates with the Larsen score and thus may serve as a marker for joint damage. In addition, it may be a promising marker reflecting subclinical atherosclerosis comorbidity in RA patients even without clinical signs of atherosclerosis, as it positively correlates with CIMT with high sensitivity and specificity.