Hematological Improvement of Patients With Active Rheumatoid Arthritis By Β-D-Mannuronic Acid (M2000) As A Novel Nsaid With Immunosuppressive Property

The aim of this study was to investigate the effect of β-d-mannuronic acid (m2000) on hematological parameters in patients with active rheumatoid arthritis. this study was conducted on 25 patients with active rheumatoid arthritis (ra) (identifier: irct2014011213739n2). m2000 was administered orally for anemic and non-anemic ra patients at a dose of 500 mg twice daily for 12 weeks. the patients were permitted to continue the conventional treatments excluding nsaids. blood samples were collected at baseline, 4 and 12 weeks after drug administration and were tested for hematological parameters. moreover, serum levels of tnf-α and il-6 were analysed before and after m2000 therapy compared to healthy controls using enzyme linked immunosorbent assay method. we found a significant increase in the count of red blood cells and also hemoglobin (hb) concentration (0.9 g/dl) in anemic patients after 12 weeks of m2000 therapy (p<0.02 and p<0.01, respectively). furthermore, our results showed an improvement in hb level (0.45 g/dl) even in non-anemic patients who were treated by m2000 (p<0.04). the leukocytosis in ra patients, significantly decreased in both anemic and non-anemic patients after 12 weeks of m2000 therapy (p<0.02 and p<0.03, respectively). the percent of neutrophils significantly increased in anemic patients (p<0.01) while in non-anemic patients it significantly decreased after 12 weeks of m2000 therapy (p<0.01). the serum levels of il-6 and tnf-α significantly decreased after 12 weeks of m2000 therapy (p<0.01 and p<0.04, respectively). m2000 improves hematological parameters in ra patients by its potent inhibitory effect on serum levels of tnf-α and il-6.