Evaluation of CXCL2 and autophagy genes expression in rheumatoid arthritis patients and its relation to cardiovascular diseases

Abstract

Background Cardiovascular disease (CVD) is among the most common comorbidity and the leading cause of mortality in rheumatoid arthritis (RA) patients. The aim of this study was to assess at the levels of CXCL2 and autophagy genes such LC3 and Beclin 1 in RA patients and how they relate to the clinical manifestations and carotid intimal medial thickness. Methods This cross-sectional study included RA patients. Sociodemographic characteristics, clinical and therapeutic data were recorded. Thorough medical and clinical examination was conducted to evaluate the disease status including the number of swollen and tender joints, visual analogue scale and disease activity score 28 (DAS28).About 5ml of whole blood was collected from each subject and CXCL2, LC3 and Beclin-1 expression levels were evaluated. The carotid intima-media thickness (CIMT) was assessed by a duplex ultrasound system. As a control group, 79 healthy individuals of matching age and gender were included. Results Seventy-nine patients with RA were included in the study with mean age 45.24 years with (SD=10.07 years). Most of them were females (87.3%) and the median duration of RA was 7 years. Approximately 85% had positive RF, while 70.9% had positive Anti CCP antibody. CXCL2 and LC3 had a statistically significant positive correlation of medium strength (P = 0.026). CXCL2 showed significant positive correlation with presence of subcutaneous rheumatoid nodules while there was a positive correlation of low strength between CXCL2 and systolic BP, diastolic BP and HAQ score. For LC3 gene expression, it was significantly correlated positively with presence of joint deformities, negatively with hypercholesteremia. There was a statistically significant positive correlation of medium strength between LC3 and CIMT in those with disease duration ≥7 years after controlling (adjusting) for patient’s age. Conclusions CXCL2 and autophagy gene expression levels (LC3 and beclin1) are positively correlated with the clinical manifestations and CIMT in RA patients. These genes may serve as predictors for CVD in RA patients.