Department of Internal Medicine, Faculty of Medicine Research and Education Hospital, Maltepe University, Istanbul, Turkey.
Department of Biochemistry, Faculty of Medicine Research and Education Hospital Central Laboratory, Maltepe University, Istanbul, Turkey.
Endocr Metab Immune Disord Drug Targets. 2021;21(8):1459-1465. doi: 10.2174/1871530320666201019115030.
The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines play an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA.
RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner.
In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission.
This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups.
RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA, according to RA in remission (p=0.03). DAS-28 was significantly high in active RA, according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively).
TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.
类风湿关节炎（RA）的发病机制尚不清楚。然而，细胞因子在这一机制中起着重要作用。我们旨在为 RA 患者的“缓解”概念带来新的方法。
RA 是一种慢性、自身免疫性、炎症性疾病，以小关节对称性多关节炎的形式出现，并伴有加重和缓解。疼痛、肿胀、压痛和晨僵是受累关节的典型表现。尽管它被视为原发性关节疾病，但也可能发生广泛的关节外受累。这是一个有趣的病理生理过程，其确切原因仍不清楚，许多环境、遗传和潜在的未知因素以混乱的方式存在。
在这项横断面研究中，我们测量了三组人群的沉降率（ESR）、C 反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、可溶性 TNF-α 受体（TNF-R）、白细胞介素（IL）-1B 和 IL-10，这三组人群分别为健康志愿者、活动期 RA 患者和缓解期 RA 患者。在活动期 RA 和缓解期 RA 中计算疾病活动评分-28（DAS-28）。
本研究纳入了 20 名健康志愿者、20 名缓解期 RA 患者和 20 名活动期 RA 患者。采集 RA 组和健康组患者的静脉血样。
RA 组中 43 名（71.6%）为女性，17 名（28.4%）为男性。对照组中 11 名（55%）为女性，9 名（45%）为男性。与健康组相比，仅活动期 RA 组的 TNF-R 显著升高（p=0.002）。与缓解期 RA 相比，活动期 RA 患者的 IL-10 显著升高（p=0.03）。与缓解期 RA 相比，活动期 RA 患者的 DAS-28 显著升高（p=0.001）。在活动期 RA 组中，ESR 和 TNF-R 呈正相关（r：0.442；p=0.048）。在活动期 RA 组中，TNF-R 与 CRP 之间也存在正相关（r：0.621；p=0.003）。健康组和活动期 RA 组的 ESR 和 CRP 之间均有显著的正相关（r：0.481；p=0.032 和 r：0.697；p=0.001）。
TNF-R 可能是主要的病理生理因子和激活的标志物。TNF-R 在揭示 TNF 对疾病的影响以及在治疗中的价值方面可能非常重要，并可通过 CRP 而不是 ESR 来监测疾病的活动和随访。
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