The Association of Serum Prolidase Enzyme Activity with the Presence of Familial Mediterranean Fever

Abstract

Objective: Uncontrolled inflammation and oxidative stress are responsible for the pathogenesis of familial Mediterranean fever (FMF) and its complications. Increased serum prolidase enzyme activity (SPEA) has been shown to correlate with inflammation and oxidative stress. This study aimed to evaluate the relationship between SPEA and FMF disease. Materials and Methods: A total of 124 participants were included in this cross-sectional study. Patients were divided into two groups depending on the presence or absence of FMF attacks. Group 1 consisted 69 patients who were attack free. Group 2 consisted of 11 patients who suffered FMF attacks. A total of 44 healthy volunteers were included in the study (Group 3). Clinical features and laboratory data were recorded. SPEA was analyzed by using spectrophotometry. Results: SPEA of Group 2 was found to be statistically significantly higher than that of Groups 1 and 3 (p=0.004 and p=0.006, respectively). SPEA was positively correlated with the presence of attack (rs=0.265, p=0.003), erythrocyte sedimentation rate (rs=0.269, p=0.003), and C-reactive protein (rs=0.199, p=0.027). The relationship between FMF attack and SPEA was evaluated by receiver operating characteristics analysis. Sensitivity and specificity were 91% and 67%, respectively, with an SPEA cut-off point of 817 U/L (AUC=0.769 [95% CI 0.626-0.912, p=0.003]). Conclusion: The FMF attack and the associated acute phase response may have an effect on increased SPEA. In FMF patients, an increased SPEA may play a role in both pathogenesis and progression of complications caused by the inflammatory process.