Copper levels in patients with rheumatoid arthritis
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Department of Paediatric Nursing, Pomeranian Medical University in Szczecin, Szczecin, Poland
Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, Szczecin, Poland
Institute of Quantum Electronics, Military Technical Academy, Warsaw, Poland
Corresponding author
Artur Mierzecki   

Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, Szczecin, Poland
Ann Agric Environ Med. 2013;20(2):312-316
Rheumatoid arthritis (RA) is a chronic, autoimmune-based disease of the connective tissue with still unknown etiology. Numerous studies have indicated the association between Copper (Cu) and ceruloplasmin (Cp) concentrations and pathogenesis of RA.

To compare the concentrations of Cu and Cp in different biological samples and their correlation with the inflammatory process, between a group of patients with RA and a control group of healthy individuals.

Material and Methods:
The study enrolled 74 Caucasian patients (20 men and 54 women), aged 29–50 (mean age 39.8±6.1 years) diagnosed with RA. The control group consisted of 30 healthy Caucasian individuals. Copper levels were assessed by atomic absorption spectroscopy.

Among RA patients the mean Cu level was significantly higher in serum and hair compartments and significantly lower in erythrocytes, compared with the control group (p<0.01). The Cp concentration was also higher in serum of RA patients (p<0.001). A statistically significant, positive correlation between the Cp serum concentration and the ESR values (rs=0.38; p<0.007) was found. No significant influence of pharmaceutical treatment (methotrexate, non-steroidal anti-inflammatory drugs, glucocorticoids, calcium, vitamin D3 and sulphasalazine) on serum Cu was found.

It seems that the ‘copper status’ in patients with RA, based on the measurement of Cu and Cp levels in blood serum is correlated with presence of the inflammatory process. The hair could serve as a useful, additional diagnostic material. Some other factors, different from the applied treatment, can probably influence the Cu levels in patients with RA.

Önal S, Naziroglu M, Çolak M, Bulut V, Flores-Arce MF. Effects of different medical treatments on serum copper, selenium and zinc levels in patients with rheumatoid arthritis. Biol Trace Elem Res. 2011; 142: 447–455.
Yazar M, Sarban S, Kocyigit A, Isikan UE. Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis. Biol Trace Elem Res. 2005; 106(2): 123–132.
Taneja SK, Mandal R. Assessment of mineral status (Zn, Cu, Mg and Mn) in rheumatoid arthritis patients in Chandigarh, India. Rheumatology Reports. 2009; 1(1): e5.
Söderlin MK, Petersson IF, Geborek P. The effect of smoking on response and drug survival in rheumatoid arthritis patients treated with their first anti-TNF drug. Scand J Rheumatol. 2012; 41(1): 1–9.
Panasiuk L, Mierzecki A, Wdowiak L, Paprzycki P, Lukas W, Godycki-Cwirko M. Prevalence of cigarette smoking among adult population in eastern Poland. Ann Agric Environ Med. 2010; 17(1): 133–138.
Cerhan JR, Saag KG, Merlino LA, Mikuls TR, Criswell LA. Antioxidant micronutrients and risk of rheumatoid arthritis in a cohort of older women. Am J Epidemiol. 2003; 157: 345–354.
Tapiero H, Townsend DM, Tew KD. Trace elements in human physiology and phatology. Copper. Biomed Pharmacother. 2003; 57(9): 386–398.
Kagan HM, Li W. Lysyl oxidase: properties, specifity, and biological roles inside and outside of the cell. J Cell Biochem. 2003; 88(4): 660–672.
Schümann K, Classen HG, Dieter HH, König J, Multhaup G, Rükgauer M et al. Hohenheim Consensus Workshop: Copper. Eur J Clin Nutr. 2002; 56: 469–483.
Mierzecki A, Strecker D, Radomska K. A pilot study on zinc levels in patients with rheumatoid arthritis. Biol Trace Elem Res. 2011; 143(2): 854–862.
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010; 62(9): 2569–2581.
Louro MO, Cocho JA, Mera A, Tutor JC. Immunochemical and enzymatic study of ceruloplasmin in rheumatoid arthritis. J Trace Elements Med Biol. 2000; 14: 174–178.
Witkowska AM, Markiewicz R, Hukałowicz R, Kuryliszyn-Moskal A, Borawska MH. Serum copper and zinc concentrations in women with rheumatoid arthritis in relation to consumption frequency of various foods. Bromat Chem Toksykol. 2002; 35(2): 147–154.
Ala S, Shokrzadeh M, Pur Shoja AM, Saravi S. Zinc and copper plasma concentrations in rheumatoid arthritis patients from a selected population in Iran. Pak J Biol Sci. 2009; 12(14): 1041–1044.
Wanchu A, Sud A, Bambery P, Prasad R, Kumar V. Plasma and peripheral blood mononuclear cells levels of Zn and Cu among Indian patients with RA. Ann Rheum Dis. 2002; 61(1): 88.
Milanino R, Frigo A, Bambara LM, Marrella M, Moretti U, Pasqualicchio M et al. Copper and zinc status in rheumatoid arthritis: studies of plasma, erythrocytes, and urine, and their relationship to disease activity markers and pharmacological treatment. Clin Exp Rheumatol. 1993; 11(3): 271–281.
Tuncer S, Kamanli A, Akçil E, Kavas GO, Seckin B, Atay MB. Trace element and magnesium levels and superoxide dismutase activity in rheumatoid arthritis. Biol Trace Elem Res. 1999; 68(2): 137–142.
Peretz A, Nève J, Famaey JP. Effects of chronic and acute corticosteroid therapy on zinc and copper status in rheumatoid arthritis patients. J Trace Elem Electrolytes Health Dis. 1989; 3(2): 103–108.
Afridi HI, Kazi TG, Brabazon D, Naher S. Association between essential trace and toxic elements in scalp hair samples of smokers rheumatoid arthritis subjects. Sci Total Environ. 2011; 412–413: 93–100.
Honkanen V, Konttinen YT, Sorsa T, Hukkanen M, Kemppinen P, Santavirta S et al. Serum zinc, copper and selenium in rheumatoid arthritis. J Trace Elem Electrolytes Health Dis. 1991; 5(4): 261–263.
Zoli A, Altomonte L, Caricchio R, Galossi A, Mirone L, Ruffini MP et al. Serum zinc and copper in active rheumatoid arthritis: correlation with interleukin 1β and tumour necrosis factor α. Clin Rheumatol. 1998; 17(5): 378–382.
Szymonik-Lesiuk S, Stryjecka-Zimmer M. Wpływ jonów cynku na peroksydację lipidów frakcji mikrosomalnej wybranych narządów królika. Biul Magnezol. 1999; 4(2): 435–441.
Dunicz-Sokolowska A, Długaszek M, Radomska K, Wlaźlak E, Surkont G, Graczyk A. Contents of bioelements and toxic metals in the Polish population determined by hair analysis. Part III. Adults aged 20–40 years. Magnes Res. 2007; 20: 43–52.
Seidel S, Kreutzer R, Smith D, McNeel S, Gillis D. Assessment of commercial laboratories performing hair mineral analysis. JAMA. 2001; 285: 67–72.
Wang CT, Li YJ, Wang FJ, Shi YM, Lee BT. Correlation between the iron, magnesium, potassium and zinc content in adolescent girls’ hair and their academic records. Chang Gung Med J. 2008; 31: 358–363.
Klevay LM, Christopherson DM, Shuler TR. Hair as a biopsy material: trace element data on one man over two decades. Eur J Clin Nutr. 2004; 58: 1359–1364.
Afridi HI, Kazi TG, Kazi N, Shah F. Evaluation of status of zinc, copper, and iron levels in biological samples of normal and arthritis patients in age groups 46–60 and 61–75 years. Clin Lab. 2012; 58(7–8): 705–717.
Akyol Ö, Kavutçu M, Canbolat O, Işik B, Durak I. A study on the relationships between some of the trace element levels of hair, nail, serum and urine in healthy subjects. Turk J Med Res. 1993; 11(2): 75–81.
Sygit K, Kollataj W, Sygit M, Kollataj B. The impact of economic factors on the realities of outpatient multi-drug treatment of chronic diseases in rural areas. Ann Agric Environ Med. 2011; 18(1): 29–34.
Al-Okbi SY. Nutraceuticals of anti-inflammatory activity as complementary therapy for rheumatoid arthritis. Toxicol Ind Health. 2012 [Epub ahead of print].
Meki AR, Hamed EA, Ezam KA. Effect of green tea extract and vitamin C on oxidant or antioxidant status of rheumatoid arthritis rat model. Indian J ClinBiochem. 2009; 24(3):280–287.
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