Possible implications of Serum levels of Tumor necrosis factor-α (TNF- α) Among Rheumatoid Arthritis Patients In Kerbala Province.
Kerbala Journal of Medicine,
Volume 3, Issue 6, Pages 795-803
Abstractbackground: Anti- Tumor necrosis factor -α (anti-TNF) therapies have shown
to slow and even halt structural joint damage in Rheumatoid Arthritis (RA).
However, therapeutic inhibition of TNF-α has approved to lead to an increase
in infections and lymphoma, hence it is mandatory to identify which patients with
rheumatoid arthritis may benefit from anti-TNF therapies.
Aim of the study: in this study we attempt to find out if any link could be drawn
between serum levels of TNF-α and some disease processes and manifestations in
RA. Such presumed link may help providing bases for patients’ selection to anti-TNF
Methods and Material: thirty two RA patients were enrolled in this study. The
patients were diagnosed based on the American College of Rhuematology (ACR)
criteria and non of them had received anti-TNF therapy. Blood sample was taken from
each patient at time of attending; sera were separated immediately and kept frozen at
–20oC until used. Disease Activity Score (DAS) was calculated using DAS28-3
formula. Radiographs were read by expert radiologists. TNF-α was measured using
solid phase Enzyme Amplified Immunoassay (EASIA), while Sandwich Enzymelinked
Immunosorbent Assay (ELISA) was used for the separate quantitative
detection of RF of the IgG, IgM and IgA classes in serum.
Results: Among the 32 Rheumatoid Arthritis (RA) patients who were enrolled in this
study, there were statistically significant positive correlations between the serum
TNF-α levels with radiological joint damage and with serum Rheumatoid Factor (RFLatex),
(p=0.015, and p=0.011 respectively). However, no correlation could be found
between serum TNF-α level with any of other disease processes and outcomes.
Conclusions: These results may further support the importance of serum TNF-α level
of erosive RA and may reflect a causal relationship between TNF- α and joint
damage. In addition, radiological changes and Latex-RF may be promising inclusion
criteria in patients’ selection for anti-TNF therapies. However, a further detailed study
using a larger sample of patients is recommended to support our results.
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