The relationship between serum levels of Toll Like Receptor-4 and oxidative stress factors with Rheumatoid Arthritis activity

Abstract

In this study, the relationship between serum levels of these biomarkers with the severity of the disease was evaluated, so that we could suggest the best and most accurate tests and effective factors in RA activity. Methods: In a cross-sectional study, 44 RA patients referring to the clinics of Tabriz University of Medical Sciences that their disease have recently been diagnosed by a rheumatologist based on ACR/EULAR 2010 criteria, were randomly chosen and entered the study. Forty-four patients that had no inflammatory disease and were compatible with the study group from the aspects of age and sex, entered the study as the case group. The activity of the disease, after thorough examinations by the physicians, were recorded using DAS28, SDAI, CDAI criteria forms. Also, 5 ml of venous blood was derived from all of the participants in the study including case and control patients and the levels of TLR-4, 8OhDG, TAC (anti-oxidant capacity), and MDA were evaluated. Results: The mean age for patients in the case group was 44.04±10.40 years. In the case group 33 patients (75%) were females and 11 patients (25%) were males and in the control group 31 patients (70.5%) were females, while 13 patients (29.5%) were males that the difference was not statistically significant (P=0.63). The results of present study depicted that the levels of oxidative stress factors including TLR-4, 8OhDG, and MDA were significantly higher in the case group than the control group (P=0.001), whereas, TAC was significantly lower in case group than the control group (P=0.001). These findings indicate high levels of inflammation and oxidative stress in a cellular level in RA patients. Our findings showed no significant relationship between the levels of MDA, 8OhDG, and TAC with the severity of the disease based on DAS28, SDAI, and CDAI (P>0.05). On the other hand, our findings depicted a significant relationship between TLR-4 and all 3 criteria of the disease severity (P=0.001). Evaluating the patients regarding the relationship between positivity of RF and anti-CCP with the measured biomarkers in the case group indicated a significant rise in TLR4 (P=0.01), MDA (P=0.015), and 8OhDG (P=0.005) along with a significant decline in TAC levels (P=0.036) in RF and anti-CCP positive patients in comparison to RF and anti-CCP negative patients.