Abstract
AbstractRheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by articular inflammation and joint destruction. The mechanism of RA pathogenesis is not fully understood, but humoral and cellular immunity are known to be involved. CD4+ T lymphocytes and cytokines released by these cells are suggested to initiate inflammation in RA. This study aimed to assess T helper 17 (Th17)/regulatory T (Treg) cell ratio and its correlation with disease activity in adult and juvenile RA. This study included 80 patients, with RA, including 40 adults (mean age: 36.4 ± 11.1 years and 40 juveniles mean age: 12.7 ± 2.2 years), and 80 healthy controls. For all patients and control subjects, patient and disease characteristics; laboratory tests for complete blood count, erythrocyte sedimentation rate, C-reactive protein (CRP), rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP), anti-nuclear antibodies (ANA), and flow cytometry to determine the numbers of Th17 and Treg cells. There was a statistically significant increase in the Th17/Treg ratio in patients with active disease compared with those with inactive disease for both adult and juvenile RA compared with controls. However, a similar significant difference was not observed between those with inactive adult and juvenile RA and controls. There were significant positive correlations between the Th17/Treg ratio and disease activity score 28 (DAS28), CRP, anti-CCP, and ANA in active adult and juvenile RA. The Th17/Treg ratio was increased in active form of adult and juvenile RA compared with inactive RA and control, indicating the Th17/Treg ratio as a potentially useful marker of disease activity.
Highlights
Rheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by articular inflammation and joint destruction
Data collected for all subjects included patient and disease characteristics; clinical examination, laboratory measurements including complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor(RF), anti-cyclic citrullinated peptide, and anti-nuclear antibodies (ANA) and flow cytometry to determine the numbers of T helper 17 (Th17) and Treg cells
We found that there were significant positive correlations between the percentage of Th17 cells and several parameters of RA activity including disease activity score 28 (DAS28), ESR, CRP, anti-CCP, RF, and ANA; there was no significant correlation between the percentage of Th17 cells and disease duration in both the adult and juvenile RA groups (►Table 6, p-value 1⁄4 0.540 and 0.562 respectively)
Summary
Ethics Statement This prospective case-control study conducted from April 2017 to May 2018 was approved by the ethics committee of the Faculty of Medicine at Bani Suef University. Data collected for all subjects included patient and disease characteristics; clinical examination, laboratory measurements including complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor(RF), anti-cyclic citrullinated peptide (anti-CCP), and anti-nuclear antibodies (ANA) and flow cytometry to determine the numbers of Th17 and Treg cells. 100 μL blood was added into two tubes (test and negative control), and 0.5 mL fixation reagent was added for 20 minutes of incubation at room temperature, followed by centrifugation to remove the supernatants. 20 μL of the antibody cocktail containing FITC-conjugated anti-FOXP3, PE-conjugated anti-CD25, and PerCP-conjugated anti-CD4 was added into the test tube only, whereas the isotype control antibody was added in the negative control tube; the tubes were incubated at room temperature in the dark for 30 minutes. Spearman’s correlation coefficient test was used for correlation analyses, and Student’s t-test was used for comparison of numerical variables between two groups. p-Values less than 0.05 were considered statistically significant at the 95% confidence level
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