الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 72 |  |  |
| | | from | 72 | | |
Abstract
Rheumatoid arthritis is a chronic multisystemic auto immune inflammatory disease. The inflammation can affect any synovial-lined diarthrodial joint. Small joints of the hands and feet are the most commonly affected joints. The synovium is the primary site of the inflammatory process, which if untreated leads to irreversible damage to the adjacent cartilage and bone.
Chemokines (chemotactic cytokines) are small inducible peptides involved in migration and retention of leukocytes in tissues under physiological and pathological conditions and they are known to have arole in inflammation. The chemokine CXCL13 (B-lymphocyte chemoattractant) is a CXC subtype member of the chemokine superfamily expected to participate in the pathogenesis of RA hence Serum level of CXCL13 have been proposed as a marker of synovitis in RA.
The aim of this study was to find out the correlation between the serum level of CXC motif chemokine13 (CXCL13) with disease activity and knee functional state in RA patient.
The present study was conducted on 23 patients with RA (21female and 2 male) and 15 healthy control subjects (13 female and 2male). The RA patients were diagnosed according to the 2010 ACR-EULAR classification criteria for RA with exclusion of patients having any disease where CXCL13 appears to be involved in disease pathogenesis like Multiple Sclerosis (MS), Hashimoto’s thyroiditis, chronic gastritis/ MALT lymphoma, graft rejection syndrome, Sjogren’s Syndrome, Systemic Lupus Erythematosis, Myastenia Gravis and Any disease other than RA affects knee function like knee osteo arthritis.
All patients were subjected to clinical evaluation of the musculoskeletal system that entailed examination of both shoulders, elbows, wrists, hand joints, and knees. Disease activity was assessed by CDAI. Functional disability was assessed by MHAQ-DI. Radiological assessment of both knees by SENS score method. Laboratory parameters including ESR, CRP, RF and ACCP were assessed in patients and serum level of CXCL13 in both patients and control subjects.
There was no statistically significant difference between patient and control group regarding age and sex. Among patients, 91.3 % were females and the age range was between 22 to 66 years. Passive smokers represented 60.9 % of the patients. EAM were presented in all patients. The mean of CDAI was 44.26 ± 18.14 and that of HAQ-DI was 0.96 ± 0.59. regarding the laboratory results, 78.3% of the patients were RF positive, 71.4% were ACCP positive, 65.2% were CRP positive and all of them had elevated ESR 1st hour with a mean of 33.48 ± 14.74 mm. regarding the radiological results, the total SENS score was 2.87 ± 1.36.
The level of serum CXCL13 among RA patients was 499.33 ± 169.87 pg/ml and it was significantly higher than in healthy control 367.87 ± 47.61 pg/ml where (p< 0.001). Serum CXCL13 showed significant correlation with ACCP among RA patients but there was no correlation between serum CXCL13 and CDAI, MHAQ-DI, total SENS score nor the other laboratory parameters.
In conclusion, serum CXCL13 is significantly higher in RA patients group than in the healthy control group and positively correlated with ACCP level and. But, it did not correlate with CDAI, MHAQ-DI, the radiological assessment by the SENS method nor the other laboratory parameters .