YKL-40 and cytokines - a New Diagnostic Constellation in Rheumatoid Arthritis?

Maria H. Kazakova 1 , Anastas Z. Batalov 2 , 3 , Nonka G. Mateva 4 , Zlatimir G. Kolarov 5  and Victoria S. Sarafian 6 , 7
  • 1 Department of Medical Biology, Faculty of Medicine, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria
  • 2 Department of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria Bulgaria
  • 3 Department of Propedeutics of Internal Diseases, University Hospital “Kaspela”, Plovdiv, Bulgaria
  • 4 Department of Medical Informatics, Biostatistics and E-learning, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
  • 5 Clinic of Rheumatology, Medical University of Sofia, Sofia, Bulgaria
  • 6 Department of Medical Biology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria Bulgaria
  • 7 Technological Center for Emergency Medicine, Plovdiv, Bulgaria


Background: Rheumatoid arthritis (RA) causes chronic inflammation and alteration of articular tissue and joints. The pathogenesis of the disease remains unclear although it is known that proinflammatory cytokines play a major role in its induction.

YKL-40 is a chitinase-like glycoprotein produced by activated macrophages, neutrophils, arthritic chondrocytes and cancer cells. It has been shown that YKL-40 is implicated in tissue remodeling, angiogenesis and inflammation.

Aim: to investigate serum and synovial YKL-40 levels in relation to IL-1β, TNF-α, and IL-6 in RA patients.

Materials and methods: Serum and synovial concentrations of YKL-40, TNF-α, IL- 6, and IL-1β were determined by ELISA in 39 patients (mean age 53.18 ± 16.54 yrs) with active RA.

Results: Serum YKL-40 levels were increased in all patients. The highest levels were found in synovial fluid (P<0.01). Our study showed a strong association between serum and synovial levels of YKL-40 and serum TNF-α and IL-1 β (P<0.05).

Conclusion: This is the first study finding a significant correlation between serum TNF-α and IL-1β and YKL-40 in active RA. We suggest that these molecules together might play a dominant role in the pathogenesis and disease activity and could possibly serve as a new diagnostic constellation in rheumatoid arthritis.

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