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TNF-α versus IL-6 Genes Expression levels in Active Rheumatoid Arthritis: Clinical and Laboratory Determinants.

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Most active rheumatoid arthritis patients on csDMARDs show higher interleukin-6 (IL-6) gene expression than tumor necrosis factor-alpha (TNF-α). Young age predicts higher IL-6 levels in these rheumatoid arthritis patients.

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Area of Science:

  • Immunology
  • Rheumatology
  • Molecular Biology

Background:

  • Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation.
  • Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) are key pro-inflammatory cytokines implicated in RA pathogenesis.
  • Conventional synthetic disease-modifying drugs (csDMARDs) are standard treatments for RA, but understanding cytokine expression in patients on these therapies is crucial.

Purpose of the Study:

  • To compare gene expression levels of TNF-α and IL-6 in active RA patients treated with csDMARDs.
  • To identify clinical and laboratory factors influencing TNF-α and IL-6 gene expression in this patient group.

Main Methods:

  • Cross-sectional study involving 108 active RA patients on csDMARDs.
  • Clinical assessment included detailed history, physical examination, and Disease Activity Score 28 (DAS28).
  • Laboratory markers (CRP, ESR, RF) and gene expression levels (TNF-α, IL-6) via qRT-PCR were analyzed.

Main Results:

  • Significant positive correlation between TNF-α and IL-6 gene expression (p<0.001, r=0.788).
  • Both cytokine expressions correlated positively with age and DAS28 (p<0.001).
  • Higher IL-6 expression observed in 81.5% of patients; associated with younger age, shorter disease duration, lower DAS28, and higher CRP/RF levels.

Conclusions:

  • Interleukin-6 (IL-6) gene expression is generally higher than tumor necrosis factor-alpha (TNF-α) in active RA patients on csDMARDs.
  • Young age is a significant predictor for relatively higher IL-6 gene expression compared to TNF-α.
  • Disease activity (DAS28), CRP, and RF levels are associated with differential cytokine gene expression patterns.