Abstract

The aim of the study was to investigate the relationship between cytokine levels and values of antibodies to cyclic citrullinated peptide (anti-CCP) and antibodies to carbamylated proteins (anti-CarP) in patients with rheumatoid arthritis (RA). Materials and methods. 106 patients with a reliable diagnosis of rheumatoid arthritis were included in the study. Determination of anti-CarP and anti-CCP was performed by enzyme immunoassay. Patients were divided into subgroups depending on the values of anti-CCP and anti-CarP. The concentration of 27 cytokines in serum was determined using multiplex xMAR technology. Results and discussion. When comparing immunological subgroups, anti-CCP(+) patients had higher concentrations of interleukin (IL) 1β, IL-1Ra, IL-2, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, fibroblast growth factor, granulocyte colony-stimulating factor (CSF), granulocyte-macrophage CSF, interferon (IFN) γ, IFN0γ-induced protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1α (MIP-1α), transforming growth factor bb, tumor necrosis factor α and vascular endothelial growth factor. IL-5, IL-9, eotaxin, MIP-1β and RANTES (regulated on activation, normal T cell expressed and secreted) values were higher in anti-CCP(–) patients. In the subgroup of anti-CCP(–) patients, an inverse correlation was found between IL-5 and total Sharpe score, between IL-9 and DAS28-CRP (Disease Activity Score with C-reactive protein calculation). In anti-Carp(–) patients (n=73) higher values of IL-17 were recorded. Conclusion. Our data support the concept of RA heterogeneity, characterised by the existence of different clinical and immunological subtypes, which may have implications for improving personalised therapy.

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