Role of modified anti-citrullinated vimentin antibodies in differentiation of rheumatoid arthritis patients from chronic hepatitis C infection patients with articular manifestations

The aim of the study was to determine the value of anti modified citrullinated and vimentin [MCV] antibodies in distinguishing Hepatitis C virus [HCV] infection patients with articular manifestations from RA patients. We studied 20 RA patients [HCV -ve], 20 chronic HCV infection patients with articular manifestation and 20 chronic HCV infection patients without articular manifestations. All patients were negative from HBV infection. All patients included in the study were subjected to routine thorough history taking, musculoskeletal examination, laboratory investigation immunological study including anti MCV antibodies by ELISA technique. There was a statistically significant high levels of anti MCV antibodies in RA patient compared with hepatitis C infection patients with or without articular manifestations. [f= 24.32, P= 0.0001]. Nineteen RA patients [95%] were anti MCV positive and only one case [5%] in each group of hepatitis C infection patients were positive for anti MCV antibodies. This indicates that anti MCV antibodies can be helpful in discriminating RA patients from chronic HCV infection patients with articular involvement

CD95 and BCL-2 expression as apoptotic markers in rheumatoid arthritis patients

Dysregulation of apoptosis of the different immune cells including the peripheral blood mononuclea, cells [PBMNC], lymphocytes have been incriminated as a pathogenetic factor in rheumatoid arthrjts [RA]. CD95 [Fas] as a death receptor and Bcl-2 as an antiapoptotic protein are among the important factors responsible for controlling lymphocytes apoptosis. To assess the expression of CD95 and Bcl-2 as apoptotic markers in PBMNs in RA patients and correlate them with RA activity and functional capacity of RA patients. Twenty RA patients and 10 healthy controls were included in this study. All patients were maintained on 7.5 mg methotrexate /week and concomitant NSAIDs. All patients were examined clinically and disease activity measures including Ritchie articular index [RAI] and the number of swollen joints [SW44] were assessed and disease activity score [DAS] was calculated for each patient. Health assessment questionnaire [HAQ] was also determined. CD95 and Bcl-2 expression on the PBMNC were assessed in serum samples by flow cytometry in patients and controls, in addition to complete blood count, Rose Waaler test and ESR. Plain X-ray for both hands was also performed for all patients to detect joint erosions. The mean CD95 expression on PBMNC was significantly higher in RA patients compared to healthy controls [t=3.222, P= 0.004]. CD95 was also significantly and positively correlated with RAI, [DAS] and [ESR] [r=0.463, r=0.736, r=0.542 respectively and P<0.05 for all]. There was no statistically significant difference regarding the mean expression of Bcl-2 in RA patients and controls [t=0.122, P>0.05]. It did not also correlate with any of the studied variables. Increased CD95 expression on PBMNC in RA patients seems to be related to the inflammatory process [disease activity] in rheumatoid disease rather than to the apoptotic process as it is correlated with disease activity measures of the studied patients. Moreover, the normal expression of Bcl-2 in PBMNC indicated that the possibility of dysregulation of apoptosis in this study is unlikely