Comparative analyses of immune marker levels in seronegative and seropositive Iraqi rheumatoid arthritis patients

Main Article Content

Ahmed Aledany
Eman T. Ali
Ali Nazar Mohammed
Falah Hassan Shari

Keywords

rheumatoid arthritis, seronegative, seropositive, CCN4, VCAM-1, MMP-3

Abstract

Background: Rheumatoid arthritis (RA) comprises an inflammation-based condition with a clinical phenotype that is mainly reliant on the occurrence of rheumatoid factor and anti-citrullinated protein antibodies. Literature indicates that seronegativity might be accompanied by higher severity of clinical symptoms, while higher disease activity, based on the recent classification criteria should also be associated with seronegativity. Aim: This investigation targets the identification of more efficient immune markers of RA seropositivity as well as examining the possibility that the latter is associated with lower severity. Methods: Serum samples from 128 RA patients, 106 seropositive and 22 seronegative, were analyzed using ELISA to determine the levels of four biomarkers: Wnt-1-induced secreted protein-1 CCN4, vascular cell adhesion molecule-1 (VCAM-1), matrix melloprotenase-3 (MMP-3), and granulocyte-macrophage colony-stimulating factor (GM-CSF). Additional clinical parameters were also investigated through a special questionnaire form that also covered demographic data. As a measure of RA activity, the parameter of joint disease activity score 28 (DAS28) was adopted. Results: Patients with seronegativity demonstrated higher RA activity, i.e., DAS28ESR score, in comparison with seropositive ones. Their sera also contained higher levels of the four tested immune markers in comparison with both seropositive patients and healthy controls. Das-28 ESR levels exhibited significant direct proportional correlations to CCN4, VCAM1, MMP3, GM-CSF, and Das-28CRP values. Conclusions: The tested four immune markers are considered biomarkers with high reliability and effectiveness to discriminate between seronegative and seropositive patients, as well as for the monitoring and prediction of RA activity and joint and bone damage in seronegative patients.

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