Khalid Khalid E
Department of Basic Medical Sciences, Faculty of Applied Medicla Sciences, Al-Baha University, Al-Baha, SAU.
Cureus. 2024 Apr 18;16(4):e58551. doi: 10.7759/cureus.58551. eCollection 2024 Apr.
Introduction Anti-citrullinated protein/peptide antibodies (ACPA) are crucial for the diagnosis and prognosis of rheumatoid arthritis (RA) and are associated with class II HLA-DRB1 alleles. The study's goal was to determine how DRB1 alleles and hematological and biochemical parameters affect ACPA production in RA patients from Sudan. Methods The study analyzed the hematological and biochemical parameters and the frequency of HLA-DRB1 alleles in 120 RA patients and 100 controls. Automated analyzers, ELISA, the latex agglutination test, and the Westergren method were utilized for hematological and biochemical testing. HLA class II alleles were genotyped using polymerase chain reaction-sequence-specific primers (PCR-SSP). The student's t-test and the chi-square () test were employed to identify significant alterations between the examined parameters and allele frequencies. Results A total of 51.7% of 120 RA patients tested positive for ACPA (ACPA+). Among those patients, the DRB1*04 and 10 alleles were significantly more prevalent (22.2% vs. 8.9%, P = 0.048 and 23.8% vs. 8.9%, P = 0.030, respectively). RA patients had significantly higher counts of platelet count test (PLT; P = 0.011), lymphocytes (LY; P = 0.000), neutrophils (NE; P = 0.025), monocytes (MO; P = 0.000), eosinophils (EO; P = 0.000), neutrophil-to-lymphocyte ratio (NLR; P = 0.006), C-reactive protein (CRP; P = 0.000), and erythrocyte sedimentation rate (ESR; P = 0.000) than controls. Patients also showed low counts of red blood cells (RBC; P = 0.003), hemoglobin (Hb; P = 0.024), mean platelet volume (MPV; P = 0.000), and basophils (BA; P = 0.048). ACPA+ RA patients had elevated white blood cells (WBC; P = 0.046), PLT (P = 0.029), and low mean corpuscular hemoglobin concentration (MCHC; P = 0.022). The hematological and biochemical parameters of ACPA+ RA patients with the DRB104 or 10 alleles did not differ significantly. Conclusions We found significant differences in hematological and biochemical parameters between RA patients and controls that had nothing to do with ACPA positivity or the frequency of DRB104 or *10 alleles.
引言 抗瓜氨酸化蛋白/肽抗体（ACPA）对类风湿关节炎（RA）的诊断和预后至关重要，且与II类HLA - DRB1等位基因相关。本研究的目的是确定DRB1等位基因以及血液学和生化参数如何影响苏丹RA患者体内ACPA的产生。
方法 本研究分析了120例RA患者和100例对照者的血液学和生化参数以及HLA - DRB1等位基因的频率。使用自动分析仪、酶联免疫吸附测定（ELISA）、乳胶凝集试验和魏氏法进行血液学和生化检测。采用聚合酶链反应 - 序列特异性引物（PCR - SSP）对HLA II类等位基因进行基因分型。采用学生t检验和卡方（χ²）检验来确定所检测参数和等位基因频率之间的显著差异。
结果 120例RA患者中共有51.7%检测出ACPA阳性（ACPA +）。在这些患者中，DRB104和10等位基因明显更为常见（分别为22.2%对8.9%，P = 0.048；23.8%对8.9%，P = 0.030）。RA患者的血小板计数检测（PLT；P = 0.011）、淋巴细胞（LY；P = 0.000）、中性粒细胞（NE；P = 0.025）、单核细胞（MO；P = 0.000）、嗜酸性粒细胞（EO；P = 0.000）、中性粒细胞与淋巴细胞比值（NLR；P = 0.006）、C反应蛋白（CRP；P = 0.000）和红细胞沉降率（ESR；P = 0.000）显著高于对照者。患者的红细胞（RBC；P = 0.003）、血红蛋白（Hb；P = 0.024）、平均血小板体积（MPV；P = 0.000）和嗜碱性粒细胞（BA；P = 0.048）计数也较低。ACPA +的RA患者白细胞（WBC；P = 0.046）、PLT（P = 0.029）升高，平均红细胞血红蛋白浓度（MCHC；P = 0.022）降低。携带DRB104或10等位基因的ACPA + RA患者的血液学和生化参数无显著差异。
结论 我们发现RA患者与对照者在血液学和生化参数上存在显著差异，这些差异与ACPA阳性或DRB104或10等位基因的频率无关。
