Abstract
In the Iraqi population, a high incidence (82.7%) of rheumatoid arthritis (RA) has been reported among the suspected patient. Many investigators studied the microbial infectious present in Iraqi patients with RA; however, to the best of our knowledge, there is no previous study detected the CMV DNA and antibodies to RA disease. Hence, the current study aimed to investigate the presence of CMV DNA and antibodies in Iraqi RA patients. A total of 58 blood samples were collected from patients with clinical signs of rheumatoid arthritis, along with 32 samples of apparently healthy individuals as a control group. These samples were tested for rheumatoid factor (RF), CMV IgM antibodies and viral DNA during the acute and the chronic periods of the autoimmune disease. The results showed that 46.6% (27/58) and 13.8% (8/58) of rheumatoid arthritis patients had positive reactions for IgM-CMV and CMV DNA, respectively, as compared to healthy individual. The highest rate of the viral occurrence was recorded in the aged and female RA patients (24 and 21 cases, respectively). Moreover, the most significant increases in RA appearance and CMV reactivation cases were observed in patients with a mean age higher than 40 years old. This finding pointed out the prevalence of viral infections mostly in RA patients aged more than 40 years old, accompanied by increased RA cases. This study concludes that patients with positive CMV must be tested for rheumatoid factor, especially when the viral DNA is present. Moreover, we recommend measuring TNF-α and IFN-γ as the proinflammatory cytokines that play an important role to protect against viral infection and prevent their reactivation in all RA patients.
Highlights
Human cytomegalovirus (CMV) has advert protein expression among the population throughout the phases of viral infection [1]
The results showed that 46.6% (27/58) of rheumatoid arthritis patients had a reaction to IgM-CMV
Than a healthy individual, but no significant differences of the cytomegalovirus reactivation were present among rheumatoid arthritis (RA) patients (x2=0.28, P>0.05)
Summary
Human cytomegalovirus (CMV) has advert protein expression among the population throughout the phases of viral infection [1]. The activated p65/p50-NF-kB heterodimer translocates into the nucleus and binds to the IE enhancer region of CMV, which initiates viral replication [7]. This molecular mechanism was shown to have a clinical correlation, in which the reactivation of latent CMV was connected with higher serum levels of TNF-α in patients with atopic dermatitis [8] and sepsis [9]. Stress catecholamines can stimulate the increase in cyclic AMP concentrations, because of viral reactivation. Through such mechanisms, persistent inflammation probably mediates the reactivation of CMV. After the age of 70 years, the incidence of RA starts to decline [15]
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