scholarly journals Intracytoplasmic expression of IL-6 and IL-17A in circulating CD4+ T cells are strongly associated with and predict disease activity in rheumatoid arthritis: A case-control study in Ghana

2020 ◽  
Author(s):  
Samuel Asamoah Sakyi ◽  
Tonnies Abeku Buckman ◽  
Daniel Antwi-Berko ◽  
Kwame Yeboah-Mensah ◽  
Dzifa Dey ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cell ◽  
Disease Activity ◽  
Case Control Study ◽  
Demographic Data ◽  
Flow Cytometric Analysis ◽  
Case Control ◽  
Healthy Controls ◽  
Severity Of The Disease ◽  
Control Study

Abstract Background T cell cytokines play important roles in the development and progression of rheumatoid arthritis (RA). Loss of Th1/Th2 and Th17/Treg balance has been reported in several inflammatory autoimmune diseases. However, their role in RA within the Ghanaian context has not been explored. Here, we evaluated the intracytoplasmic CD4 + T cell cytokine patterns in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity. Methods This case-control study included 48 newly-diagnosed RA patients and 30 healthy controls from two major hospitals in Ghana. Validated structured questionnaires were administered to obtain demographic data; blood samples were collected and processed for flow cytometric analysis. Results IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A, IL-6/IL-4 and IL-17/IL-10 expression were significantly higher in RA cases compared to the healthy controls. The expression of IL-6 (0.00 (0.00-0.98) vs 0.82 (0.34–1.10) vs 1.56 (1.39–1.68), p < 0.0001), IL-17A (0.00 (0.00-0.02) vs 0.19 (0.09–0.30) vs 0.99 (0.64–1.25), p < 0.0001) and IL-17A/IL-10 (0.00 (0.00-0.39) vs 0.15 (0.09–0.26) vs 0.88 (0.41–1.47), p < 0.0001) increased significantly from the healthy controls through RA patients with low DAS scores to RA patients with moderate DAS scores. IL-6 (β = 0.681, r2 = 0.527, p < 0.0001), IL-17A (β = 0.770, r2 = 0.593, p < 0.0001) and IL-17A/IL-10 (β = 0.677, r2 = 0.452, p < 0.0001) expression were significantly directly associated with DAS28 scores. IL-6 (Cutoff = 1.32, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) and IL-17A (Cutoff = 0.58, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) presented with the best discriminatory power in predicting moderate DAS scores from low DAS scores. Conclusion Th1 and Th17 related cytokines predominate in the pathophysiology of RA; with IL-6 and IL-17 being principally and differentially expressed based on the severity of the disease. IL-6 and IL-17A could serve as useful prognostic and disease-monitoring markers in RA in the African context.

scholarly journals Intracytoplasmic Expression of IL-6 and IL-17A in Circulating CD4+ T Cells Are Strongly Associated with and Predict Disease Activity in Rheumatoid Arthritis: A Case-Control Study in Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Samuel Asamoah Sakyi ◽  
Tonnies Abeku Buckman ◽  
Daniel Antwi-Berko ◽  
Kwame Yeboah-Mensah ◽  
Dzifa Dey ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cell ◽  
Disease Activity ◽  
Case Control Study ◽  
Demographic Data ◽  
Flow Cytometric Analysis ◽  
Case Control ◽  
Healthy Controls ◽  
Severity Of The Disease ◽  
Control Study

Background. T cell cytokines play important roles in the development and progression of rheumatoid arthritis (RA). Loss of Th1/Th2 and Th17/Treg balance has been reported in several inflammatory autoimmune diseases. However, their role in RA within hitherto rare Ghanaian context has not been explored. Here, we evaluated the intracytoplasmic CD4+ T cell cytokine patterns in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity. Methods. This case-control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from two major hospitals in Ghana. Validated structured questionnaires were administered to obtain demographic data; blood samples were collected and processed for flow cytometric analysis. Results. IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A, IL-6/IL-4, and IL-17/IL-10 expressions were significantly higher in RA cases compared to the healthy controls. The expression of IL-6 (0.00 (0.00-0.98) vs. 0.82 (0.34-1.10) vs. 1.56 (1.39-1.68), p<0.0001), IL-17A (0.00 (0.00-0.02) vs. 0.19 (0.09-0.30) vs. 0.99 (0.64-1.25), p<0.0001), and IL-17A/IL-10 (0.00 (0.00-0.39) vs. 0.15 (0.09-0.26) vs. 0.88 (0.41-1.47), p<0.0001) increased significantly from the healthy controls through RA patients with low DAS scores to RA patients with moderate DAS scores. IL-6 (β=0.681, r2=0.527, p<0.0001), IL-17A (β=0.770, r2=0.593, p<0.0001), and IL-17A/IL-10 (β=0.677, r2=0.452, p<0.0001) expressions were significantly directly associated with DAS28 scores. IL-6 (cutoff=1.32, sensitivity=100.0%, specificity=100.0%, accuracy=100.0%, and AUC=1.000) and IL-17A (cutoff=0.58, sensitivity=100.0%, specificity=100.0%, accuracy=100.0%, and AUC=1.000) presented with the best discriminatory power in predicting moderate DAS scores from low DAS scores. Conclusion. Th1- and Th17-related cytokines predominate in the pathophysiology of RA, with IL-6 and IL-17 being principally and differentially expressed based on the severity of the disease. IL-6 and IL-17A could serve as useful prognostic and disease-monitoring markers in RA in the African context.

scholarly journals SAT0077 CARDIOVASCULAR RISK ASSESSMENT WITH CAROTID ULTRASONOGRAPHY IN ADDITION TO THE TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS PATIENTS: A CASE CONTROL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 973-973
Author(s):  
R. Gonzalez Mazario ◽  
J. J. Fragio-Gil ◽  
P. Martinez Calabuig ◽  
E. Grau García ◽  
M. De la Rubia Navarro ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Disease Duration ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Controls ◽  
Carotid Ultrasonography ◽  
Control Study

Background:Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor.Objectives:To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors.Methods:A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors).Results:A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p<0.001).Table 1.Table 2.RA basal characteristicsDisease duration (years)16,98 (11,38)Erosions (X-Ray of hands/feet)163 (81,5%)Seropositive (RF/anti-CCP)146 (73%)Extra-articular symptoms44 (22%)Intersticial difusse lung disease10 (5%)Rheumatoid nodules14 (7%)Prednisone use103 (51,5%)Median dose of Prednisone last year (mg)2,34 (2,84)sDMARDsMethotrexate104 (52%)Leflunomide29 (14,5%)Hydroxycloroquine9 (4,5%)bDMARDs89 (44,5%) TNFi41 (20,5%) Abatacept15 (7,5%) IL6i22 (11%) RTX11 (5,5%)JAKi26 (13%) Baricitinib11 (5,5%) Tofacitinib15 (7,5%)DAS 28-ESR3,1 (2,3, 3,9)SDAI7,85 (4,04, 13,41)HAQ0,88 (0,22, 1,5)RF (U/mL)51 (15, 164,25)Anti-CCP (U/mL)173 (22, 340)Patients showed higher intima-media (both right and left) thickness compared to controls (p<0.006). Moreover it was also related to the disease duration and DAS28 score (p<0.001). A higher plaque account was noted in cases(p<0.004) and it was also related to the disease duration (p<0.001).Conclusion:RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor.Disclosure of Interests:None declared

scholarly journals Is Ultrasound a Better Target than Clinical Disease Activity Scores in Rheumatoid Arthritis with Fibromyalgia? A Case-Control Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0118620 ◽  
Author(s):  
Rafael Mendonça da Silva Chakr ◽  
João Carlos Tavares Brenol ◽  
Marina Behar ◽  
José Alexandre Mendonça ◽  
Charles Lubianca Kohem ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Case Control Study ◽  
Case Control ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Control Study

scholarly journals Patients with rheumatoid arthritis with moderate or high disease activity benefit from multidisciplinary rehabilitation: a nested case-control study

2021 ◽  
Author(s):  
◽  
Bernardo Matos da Cunha ◽  
Bruno Silva de Araújo Ferreira ◽  
Camila Sodré Mendes Barros ◽  
Jesiniana Rodrigues Silva ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Case Control Study ◽  
Health Assessment ◽  
Case Control ◽  
Rehabilitation Program ◽  
Before And After ◽  
Post Hoc ◽  
Nested Case Control ◽  
Control Study

AbstractBackgroundrheumatologists recognize the importance of rehabilitation in patients with rheumatoid arthritis (RA), but they are not confident if patients with significant disease activity would benefit from it. Objective: To verify if rheumatoid arthritis patients with moderate to severe inflammatory activity (MHA) improve functional capacity (FC) after a comprehensive rehabilitation program.MethodsNested case-control study. RA patients who completed a rehabilitation program between June 2014 and December 2017 were included. The interventions were prescribed according to the rehabilitation team’s discretion. FC was assessed with Health Assessment Questionnaire Disability Index (HAQ) and compared between before and after interventions. The group which improved at least 50% in CDAI was compared to the group which achieved <50%.ResultsWe included 46 patients with complete HAQ and baseline CDAI data, with a mean age of 53.6 years and a mean disease duration of 11.8 years. HAQ and CDAI improved on average 0.481 (± 0.500) and 14.2 (± 16.7), respectively. Patients who improved CDAI tended to have a greater mean HAQ difference (0.6 vs. 0.3; p = 0.058). Conversely, patients who did not improve disease activity had a HAQ reduction of 0.3 (± 0.4). Post-hoc analysis was performed on the group of 9 patients with baseline CDAI ≤10. A mean baseline CDAI of 5.2 and a mean HAQ difference of 0.319 (0.079; 0.56; p = 0.016) were found.ConclusionsAfter rehabilitation, RA patients with sustained MHA improved FC similarly to patients with baseline mild activity or remission. Thus, patients with RA and MHA may benefit from rehabilitation concurrently with drug treatment. This study suggests that the range of improvement in FC with rehabilitation appears to have an additive effect to the drug therapy.

scholarly journals Longitudinal Occurrence and Predictors of Patient‐Provider Discordance Between Global Assessments of Disease Activity in Rheumatoid Arthritis: A Case–Control Study

2019 ◽  
Vol 72 (1) ◽  
pp. 18-26
Author(s):  
Divya N. V. Challa ◽  
Zoran Kvrgic ◽  
Cynthia S. Crowson ◽  
Eric L. Matteson ◽  
Thomas G. Mason ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

scholarly journals Measurement of serum interferon alpha in Egyptian patients with systemic lupus erythematosus and evaluation of its effect on disease activity: a case-control study

Reumatismo ◽  
2020 ◽  
Vol 72 (3) ◽  
pp. 145-153
Author(s):  
A. Fayed ◽  
M.M. El Menyawi ◽  
M. Ghanema ◽  
O. Shaker ◽  
R. Elgohary
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Interferon Alpha ◽  
Lupus Erythematosus ◽  
Case Control Study ◽  
Case Control ◽  
Complement C3 ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Control Study

Much evidence highlighted the role of interferon alpha (IFN-α) in systemic lupus erythematosus (SLE) and suggested its possible role in assessing disease activity. We measured serum IFN-α in Egyptian SLE patients in order to determine a cutoff value that can be used to distinguish patients from healthy controls and explored its clinical value in monitoring disease activity and different aspects of the disease, in particular lupus nephritis. This cross-sectional, case-control study was conducted on 59 SLE patients and 30 healthy controls. Serum IFN-α was measured in all participants using sensitive enzyme-linked immunosorbent assay (ELISA). SLE patients underwent assessment of disease activity using the SLE disease activity index-2000 (SLEDAI-2K) as well as an evaluation of proteinuria, complement C3 and C4, and serology. Patients with evidence of renal involvement underwent renal biopsy. The median serum IFN-α was 81.8 pg/mL (interquartile range [IQR] 63.4:102.4), which was significantly higher than in healthy controls (median 10.3 pg/mL [IQR 7.3:11.6]) (p<0.001). At serum level of 14.7 pg/mL, IFN-α has high sensitivity and specificity to discriminate SLE patients from controls, with high positive and negative predictive values. Serum IFN-α was not associated with markers of disease activity, clinical features and anti-double stranded DNA. Furthermore, it was not associated with markers of renal activity, including proteinuria, C3 and C4 complement factors and histopathology renal classes. Despite elevated levels of serum IFN-α in SLE patients, it is not possible to use it as a biomarker for disease activity.

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