الفهرس 
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Abstract
RA is a chronic inflammatory autoimmune disease that causes chronic inflammation of the synovium with subsequent destruction and deformity of the joints.
The etiology of RA remains unclear, but it is known to be associated with genetic and environmental factors. Autoimmunity plays a pivotal role in both its chronicity and progression.
PAR2 is a G-protein coupled receptor activated by serine proteinases, which liberates a tethered ligand, by cleaving the N-terminus of the receptor, and initiates several intracellular signal pathways.PAR2 with putative proinflammatory roles which remain poorly defined in human diseases. selective activation of PAR2 promotes joint swelling and synovial hyperaemia in mice and has been shown to promote cytokine release from human cell lines in vitro. Recently PAR2 was shown to be upregulated in synovium from patients with RA.
The aim of this study was to evaluate the expression of PAR2 on peripheral blood monocytes and T-cells in patients with RA and its correlation with disease activity.
The present study was conducted on 40 RA patients selected from the attendance of Menoufia University Hospitals ,Out-patient Clinic of physical medicine and rehabilitation department, The 40 patients diagnosed as RA according ACR/EULAR 2010 criteria; 20 of them were in activity (19 females and 1 male, their ages ranged from 22 to 61 years) and 20 patients were in remission (18 females and 2 males, their ages ranged from 30 to 65 years) In addition to 16 apparently healthy, age and gender matched subjects
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were involved as a control group (3 males and 13 females, their ages ranged from 30 to 62 years).
All patients were subjected to Clinical assessment, Disease activity assessment, Laboratory Investigations (RF, ESR, Anti-CCP, and CRP) and evaluation of PAR2 expression on peripheral blood monocytes and T- cells by flowcytometry.
The study results revealed that:
There were no significant differences between the studied groups regarding the percentage of CD3+ T-cells expressing PAR2 and the intensity of expression of PAR2 onCD3+T-cells (P-value>0.05).
Regarding PAR2 expression on monocytes there were highly statistically significant differences in the percentage of monocytes expressing PAR2 between patients in activity and remission groups, between patients in activity and control groups and between patients in remission and control groups (P- value < 0.001, < 0.001, <0.01 respectively). Also comparing PAR2 MFIR on monocytes between patients in activity and controls revealed a highly statistically significant differences between them (P-value < 0.001).While there were no significant differences regarding PAR2 MFIR when comparing patients in activity and remission and between patients in remission and controls (P-value > 0.05).
No statistically significant differences were found between patients with moderate and high disease activity regarding PAR2 expression on both CD3+ T-cells and monocytes (P-value > 0.05).
Highly significant positive correlation between PAR2 expression on monocytes and ESR (P-value < 0.001).While no significant
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correlation was found between PAR2 expression on CD3+ T-cells and ESR (P-value >0.05).
Highly significant positive correlation between PAR2 expression on monocytes and DAS 28 (P-value < 0.001).While no significant correlation was found between PAR2 expression on CD3+ T-cells and DAS28 (P-value >0.05).
Comparison between RF positive and negative patients regarding PAR2 expression revealed that there were significant association between higher levels of PAR2 expression on monocytes and RF positivity (P-value =0.01).While there were no significant association between PAR2 expression on CD3+ T-cells and RF positivity (P-value > 0.05).
Comparison between Anti-CCP positive and negative patients regarding PAR2 expression revealed that there were highly significant association between higher levels of PAR2 expression on monocytes and Anti-CCP positivity (P-value <0.001). While there were no significant association between PAR2 expression on CD3+ T-cells and Anti-CCP positivity (P-value > 0.05).
Comparison between CRP positive and negative patients regarding PAR2 expression revealed that there were no significant association between higher levels of PAR2 expression on both (monocytes and CD3+ T-cells) and CRP positivity (P-value > 0.05).