تاثير علاج CD 20 inhibitors مقارنة بعلاج TNF ? inhibitors IL - على 17 في مرضى التهاب المفاصل الروماتويدى الفعال == Effects of CD20 Inhibitor Therapy in Comparison to TNF ? Inhibitor Therapy on Serum IL - 17 in Patients with Active Rheumatoid Arthritis
Author name:
محمد حنون داود
Supervisor name:
هالة غازي محمود | محمد هادى العصامى
General topic:
Medicine
Specific topic:
Clinical Biochemistry
Degree:
Master
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1581 - p.pdf
Abstract:
Rheumatoid arthritis (RA) is a chronic , systemic , inflammatory disorder that may affect many tissues and organs ,but principally attacks flexible( synovial ) Joints , the pathogenesis of RA is not completely understood .Objective : To evaluate the effects of CD20 inhibitor therapy in comparison to effects of TNF α inhibitor therapy on serum IL - 17 in patients with active rheumatoid arthritis.Setting : This study was performed during the period from October 2012 to May 2013 . The subject were selected from the patients attending the out patients clinic in Medical city /Baghdad Teaching Hospital / Rheumatology unit and the laboratory tests were done inMedical City /Teaching Laboratories The study include 70 patients and 20 healthy control individuals , their age range from 20 - 68 years . The patients were divided into three groups : - Group (1)consist of 20 RA patients received disease modifying anti rheumatic drugs(DMARDs ) . - Group(2) consist of 25 RA patients received biological treatment Etanercept ( anti TNFα ). - Group(3) consist of 25 RA patients received biological treatment Rituximab ( anti CD20).Methods : Enzyme Linkade Immunosorbent Assay ( ELISA ) test was used for the determination of IL - 17 , Leptin and hsCRP , while colorimetric method was used for the determination of uric acid . Rheumatoid factor ( RF ) was detected by serological investigation . The only anthropometric parameter in this study was body mass index( BMI). The current results revealed that serum levels of hsC - RP , ESR and RF were significantly higher in patients than in healthy controls. While serum level of IL - 17 was significantly lower in patients who are undertreatment than in healthy control ( P < 0.05 ).There was significant difference among groups : serum level of IL - 17 : - in group 1 higer than in group 2 ( P < 0.05 ) - in group 2 higer than in group 3 ( P < 0.05 ) There was no significant difference between all the groups in this study regarding level of uric acid ( P > 0.05 ) and the level of the leptin ( P > 0.05 ) , also significant positive correlation among each of ESR , hsC - RP , IL - 17 ( P < 0.05 ) and ( 0 < r < 1+ ).Conclusion : IL - 17 has a significant effect on the pathogenesis of RA . IL - 17 level is higher in normal people and people with RA receiving DMARDs compared to RA patients receiving biological treatment. In patients with biological treatment , these received TNFα inhibitor ( Etanercept ) has a high IL - 17 level compared to these received CD20 inhibitor ( Rituximab ) . IL - 17 can be used as a marker for RA activity.
