RESUMO
INTRODUCTION: Axial spondyloarthritis (SpA) is a common inflammatory arthritis characterized by axial skeletal inflammation, enthesitis, and association with HLA-B27. Pro-inflammatory cytokines play important roles in the regulation of inflammatory response and seem to be good candidates involved in the development of this pathology. AIM: To assess the influence of the functional polymorphisms of single nucleotide polymorphims (SNPs) of IL-1 and IL-1 Ra in SpA susceptibility Tunisian patients. METHODS AND RESULTS: One hundred and one patients and 100 ethnic-matched healthy controls were genotyped. Susceptibility to SpA was showed with SNP's: C/T of IL-1α (-889) (p=0.0001) and 1/1 of IL-1Ra (p<10-3). Analysis of SpA patients according to clinical behavior of the disease reveled the influence of these polymorphisms in SpA course. Indeed, individuals carrying the allele T (+3954) of IL-1ß and allele 1 of IL-1Ra had an increased risk of peripheral arthritis (p=0.047, p=0.05, respectively). Also the 1/1 genotype of IL-1Ra was significantly decreased in SpA patients having an active disease (BASDAI>4) (p=0.033). CONCLUSION: Genetic polymorphisms of pro-inflammatory IL-1/IL-1Ra cytokines seem to be involved in susceptibility and clinical course of SpA in Tunisian patients.
Assuntos
Proteína Antagonista do Receptor de Interleucina 1/genética , Interleucina-1/genética , Interleucina-1alfa/genética , Espondilartrite/genética , Adulto , Idoso , Alelos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Interleucina-1beta/genética , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Espondilartrite/fisiopatologia , Tunísia , Adulto JovemRESUMO
BACKGROUND: It is well documented that in early rheumatoid arthritis, anti-CCP antibodies have better diagnostic value than rheumatoid factors and anti-keratin antibodies. However, their role is less well defined in patients with established or long duration disease. AIM: To evaluate and to compare diagnostic performances of anti- CCP, anti-keratin, IgM and IgA rheumatoid factors in established rheumatoid arthritis. METHODS: In a cross-sectional study, 90 patients with established rheumatoid arthritis and 100 controls were tested for these autoantibodies. The association of these markers with disease activity and severity was investigated. The sensitivity and specificity were calculated for each of four tests, using the clinical diagnosis as the gold standard. RESULTS: The anti-CCP and IgM rheumatoid factor exhibited the best diagnostic value. None of the tested antibodies had any significant association with the disease activity score (DAS28). After adjustment by multiple linear regression, only anti-CCP positivity was found to be significantly associated with erosive disease. CONCLUSION: In long duration rheumatoid arthritis, anti-CCP and IgM rheumatoid factor have similar diagnostic value. However anti- CCP are useful in seronegative patients. They are also a reliable marker of severe erosive disease.
