scholarly journals Clinical Efficacy of Methotrexate Combined with Iguratimod on Patients with Rheumatoid Arthritis and Its Influence on the Expression Levels of HOTAIR in Serum

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jingya Tan ◽  
Jiaqiang Dan ◽  
Yi Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Physical Examination ◽  
Clinical Efficacy ◽  
Control Group ◽  
Expression Levels ◽  
Qrt Pcr ◽  
Therapeutic Value ◽  
Healthy Control ◽  
Research Objects

Objective. This study was designed to explore the clinical efficacy of methotrexate combined with iguratimod on patients with rheumatoid arthritis (RA) and its influence on the expression levels of HOTAIR in serum. Methods. A total of 268 RA patients were selected as research objects, 145 patients received methotrexate alone were used as a control group (CG), 123 patients received methotrexate combined with iguratimod were taken as a research group (RG), and serum of 60 healthy people undergoing physical examination was selected as a healthy control group (HCG). The therapeutic value of two therapeutic methods for RA was compared, and the HOTAIR expression in serum was detected by qRT-PCR. Results. Compared with methotrexate used alone, the joint use of methotrexate and iguratimod could provide better clinical efficacy for RA patients and would not increase the incidence of adverse events. HOTAIR was highly expressed in the serum of RA patients, and its expression decreased after treatment. Conclusion. Combination therapy of methotrexate and iguratimod is a safe and effective way to treat RA patients, which can be popularized clinically.

scholarly journals Systemic Review and Meta-Analysis of the Clinical Efficacy and Adverse Effects of Zhengqing Fengtongning Combined with Methotrexate in Rheumatoid Arthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Xiu-min Chen ◽  
Run-yue Huang ◽  
Qing-chun Huang ◽  
Yong-liang Chu ◽  
Jing-yao Yan
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Adverse Drug Reactions ◽  
Clinical Efficacy ◽  
Systemic Review ◽  
Tender Joint Count ◽  
Control Group ◽  
Drug Reactions ◽  
Chinese Medicines ◽  
Better Than

Chinese medicines are gaining wider acceptance. They have been used for treating rheumatoid arthritis (RA) for thousands of years, and the need to investigate the interaction between Chinese medicines and western medicines is widely recognized. In this study, a large number of RCTs and CCTs were analyzed to systematically assess the effects and adverse events of Zhengqing Fengtongning (ZQFTN) for RA. Eleven studies that contained 956 participants (508 in the treatment group; 448 in the control group) were included. The results showed that although ZQFTN combined with methotrexate MTX could not decrease the swollen joint count and tender joint count of RA patients better than MTX alone, the combination therapy might relieve the duration of morning stiffness (SMD: −16.06; 95% CI: −28.77 to −3.34), reduce laboratory indexes (RF: SMD: −10.84; 95% CI: −19.39 to −2.29; ESR: SMD: −7.26; 95% CI: −11.54 to −2.99; CRP: SMD: −3.66; 95% CI: −5.94 to −1.38), and improve the overall effect (RR: 1.08; CI: 1.01 to 1.16) better than monotherapy. The combination therapy was significantly better in controlling adverse drug reactions (RR: 0.60; 95% CI: 0.46 to 0.79). Through this systematic review, we found that ZQFTN combined with MTX for the treatment of RA might have better clinical efficacy than MTX only and might be superior in terms of controlling adverse drug reactions.

scholarly journals Expression of AIM2 in rheumatoid arthritis and its role on fibroblast-like synoviocyte

2020 ◽  
Author(s):  
fujuan qiu ◽  
Chen Yong ◽  
Qiu Fujuan ◽  
Zhao Xiaofeng ◽  
Xiao Changhong
Keyword(s):  
Rheumatoid Arthritis ◽  
Mtt Assay ◽  
Control Group ◽  
Expression Levels ◽  
Potential Target ◽  
Caspase 1 ◽  
Significant Difference ◽  
And Migration ◽  
Fibroblast Like Synoviocytes ◽  
Proliferation And Migration

Abstract Background To determine whether any differences of AIM2 inflammasome expression levels between rheumatoid arthritis (RA) and osteoarthritis (OA) and investigate the effects of AIM2 when transferred into RA fibroblast-like synoviocytes (RA-FLS).Methods Serum AIM2 levels between OA and RA patients were compared by ELISA. Different expression levels of AIM2, ASC, Caspase-1 and IL-1β between RA and OA synovium were semi-quantified by RT-qPCR and immunohistochemical (IHC) staining. IHC staining were recorded by H scores, and determine the correlation with ESR and CRP levels of RA patients. SiRNA AIM2 was transferred to RA-FLS and observe its effects on proliferation and migration by MTT assay and transwell test respectively.Results In RA sera, no significant difference was observed between OA and RA patients. However, in affected knee synovium, AIM2, ASC, Caspase-1 and IL-1β were expressed higher in RA than that of OA. Plus, H score of AIM2, ASC, and IL-1β were positively correlated to ESR and CRP levels in RA patients. After transferred AIM2 siRNA to FLS and incubation for 48 hours, the proliferation of FLS were significantly inhibited, and the apoptosis rate were significantly increased compared to FLS in control group. However, no effect on migration was detected.Conclusions AIM2 participated in the proliferation of FLS, and might be a potential target for therapy.

Increased Expression of TLR2 and TLR4 in Mononuclear Cells in Patient with Immune Thrombocytopenic Purpura.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3847-3847 ◽  
Author(s):  
Yunfeng Cheng ◽  
Shanhua Zou ◽  
Feng Li
Keyword(s):  
Plasma Concentration ◽  
Mrna Expression ◽  
Mononuclear Cells ◽  
Control Group ◽  
Gene Expressions ◽  
Expression Levels ◽  
Tnf Α ◽  
Healthy Control ◽  
Ifn Γ ◽  
Mrna Expression Levels

Abstract Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by platelet destruction resulting from autoantibodies against self-antigens and T-cell mediated cytotoxicity. Toll-like receptors (TLRs) are pattern recognition receptors important in mediating the immune response and their activation can lead to production of cytokines. Recent data suggest that TLR2 and TLR4 are crucial for the production of inflammatory cytokines and play central role in autoimmune diseases, yet little is known about their roles in ITP. Here we examined the gene expressions of TLR2 and TLR4 in ITP patients. We hypothesize that significant differences will exist between pre-treatment and post-treatment in ITP patients with similar changes reflected in the plasma concentration of cytokines. Total RNA was extracted from mononuclear cells obtained from 12 ITP patients and 15 healthy subjects. TLR2 and TLR4 mRNA expression levels were analyzed using a quantitative real-time PCR method and their protein expressions were validated by western blot. Plasma concentrations of cytokines IL-2, IFN-γ and TNF-α were measured by ELISA. Correlation analyses were carried out between the mRNA expression levels of TLR2 or TLR4 and the plasma levels of IL-2, IFN-γ and TNF-α. The gene expression of TLR2 and TLR4 were significantly increased in ITP patients comparing to healthy control group (p < 0.05 and p < 0.01, respectively). In addition their mRNA expression levels were decreased back into normal range after remission in 8 patients (p > 0.05, compared to healthy control group). Significantly positive correlations were found between the TLR2 mRNA expression level and the plasma concentration of IFN-γ or TNF-α (R = 0.75, p < 0.05; R = 0.83, p < 0.05, respectively). Changes in the gene expression of TLR4 and in the plasma concentration of IFN-γ or TNF-α were also significantly correlated (R = 0.82, p < 0.05; R = 0.88, p < 0.05, respectively). Directional changes in TLR2 / TLR4 and IFN-γ /TNF-α expression were concordant. However, there was no correlation found between TLR2 / TLR4 and IL-2. Differences in TLR2 and TLR4 expression strongly correlated with changes in IFN-γ and TNF-α suggest that the increased gene expressions of TLR2 and TLR4 in ITP patients may contribute to the pathophysiological progression of this disease by increasing the secretion of IFN-γ and TNF-α. Additional studies need to be performed to further clarify the role of TLRs -cytokines pathway in ITP.

Evaluation of serum microRNA expression profile in panic disorder patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S595-S595
Author(s):  
F.P. Çökmüş ◽  
E. Özmen ◽  
T. Alkın ◽  
M.B. Batır ◽  
F.S. Çam
Keyword(s):  
Panic Disorder ◽  
Mirna Expression ◽  
Venous Blood ◽  
Clinical Information ◽  
Serum Levels ◽  
Healthy Control Group ◽  
Control Group ◽  
Receptor Subtypes ◽  
Expression Levels ◽  
Healthy Control

IntroductionEven though it has begun to be investigated in recent years, studies of microRNA (miRNA) in anxiety disorders are limited. Our research is the first miRNA expression study in panic disorder, which excludes of drug use and additional psychiatric disorders.ObjectiveWe aimed to determine the availability of miRNAs as biomarkers in the serum levels of panic disorder and to demonstrate the changing expression of miRNAs.MethodsIn the research, 35 panic disorder patients and 35 healthy controls were administered a socio-demographic and clinical information form, SCID-I, PDSS. 2 tubes of peripheral venous blood were taken from each group for genetic evaluation. miRNA expression analysis was performed in those samples by the RT-PCR method.ResultsCompared with the healthy control group, 8 miRNA expression levels were found different in panic disorder group. Five of them were up-regulated and 3 of them were down-regulated. There was no correlation between the level of miRNA expression and PDSS total score and PDSS sub-items. miR-1297 and miR-4465 expression levels were statistically significant between the two groups. Both miRNAs are also known to arrange the gene regions that affect GABAA receptor subtypes.ConclusionsmiR-1297 and miR-4465 regulate the GABAA gene that is thought to play a role in the etiology of panic disorder (Wong et al., 2014, Wang 2016). In panic disorder group, miR-1297 and miR-4465 expression levels were found to be up-regulated from the healthy control group.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals C1GALT1 expression is associated with galactosylation of IgA1 in peripheral B lymphocyte in immunoglobulin A nephropathy

2019 ◽  
Author(s):  
Yue Xing ◽  
Lina Li ◽  
Yaru Zhang ◽  
Fanghao Wang ◽  
Dandan He ◽  
...  
Keyword(s):  
B Cells ◽  
B Lymphocyte ◽  
Meta Analysis ◽  
Mrna Level ◽  
Immunoglobulin A ◽  
Control Group ◽  
Expression Levels ◽  
Medical Network ◽  
Significant Difference ◽  
Healthy Control

Abstract Background More and more studies demonstrated that genetic variation at C1GALT1 influences Gd-IgA1 level in IgAN. However, whether the expression of β1, 3-galactosyltransferase (β1, 3Gal-T) was influenced may provide insights into how Gd-IgA1 levels are controlled in IgAN. Methods Thirty IgAN patients diagnosed in Tianjin Medical University General Hospital from April to September 2018 and 30 healthy volunteers whose age and gender matched with patients were enrolled in this study. Total Gd-IgA1 levels in plasma were determined by ELISA and C1GALT1 levels were determined by RT-PCR. Four databases (PubMed, EMBASE, CNKI, WanFang Medical Network) were searched to identify eligible studies that evaluated a difference in the expression of C1GALT1 in IgAN patients compared with total controls (non-IgAN and health controls). The C1GALT1C1 expression levels, which was indispensable to β1, 3Gal-T of IgA1, was also been compared. Results Gd-IgA1 levels were remarkable higher in IgAN patients compared with healthy control. The expression levels of C1GALT1 gene were remarkably down-regulated in IgAN patients compared with healthy control. And the mRNA level of C1GALT1 was inversely correlated to Gd-IgA1 levels. In meta-analysis, six articles including 316 participants that analyzed the expression of β1, 3Gal-T were met inclusion criteria. There was no significant difference in the expression of C1GALT1 between IgAN patients compared with controls. And we found patients with IgAN had lower levels of C1GALT1 gene expression in the B cells compared to controls. The C1GALT1C1 levels in the IgAN patients were not different from the levels in the control group, which were unchanged no matter according to different ethnic population, different control group and different cell source. Two studies including 46 persons compared enzymatic activity of β1, 3Gal-T in B cells, and the result showed the β1, 3Gal-T activity was decreased in B cells. Conclusions We found expression levels of C1GALT1 were remarkably downregulated in IgAN patients and negatively correlated with higher levels of Gd-IgA1. Subsequent meta-analysis validated the low expression and activity of β1, 3Gal-T in B cells in patients with IgAN. However, there was no apparent disparity in the aspect of C1GALT1C1 expression between IgAN and control groups.

AB0043 THE IMBALANCE OF T FOLLICULAR REGULATORY CELL AND T FOLLICULAR HELPER CELL IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1324-1325
Author(s):  
R. Su ◽  
Y. Y. Wang ◽  
F. Y. Hu ◽  
X. Zheng ◽  
Y. Liu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Peripheral Blood ◽  
Control Group ◽  
Healthy Controls ◽  
Regulatory Cells ◽  
Regulatory Cell ◽  
Helper Cells ◽  
Follicular Helper ◽  
Healthy Control ◽  
T Follicular Helper Cell

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease which can lead to severe joint damage and disability.The relationship between antibodies and rheumatoid arthritis has long been well established. Recently, many studies have found that T follicular regulatory cells(Tfr) and T follicular helper cells (Tfh) are closely related to antibody generation on lymphoid follicular germinal centers (GCs)[1-2]. Tfr cells can inhibite the GC reaction and suppress production of high-affinity antibodies. The dysregulation of Tfh cells can lead to the production of autoantibodies by B cells.Objectives:To examine the expression of circulating T follicular regulatory cell (Tfr) and T follicular helper cell and its subsets(Tfh1 Tfh2 Tfh17) in RA patients and healthy control group.Methods:Level of Tfr and Tfh1,Tfh2 and Tfh17 cells in the peripheral blood of 17 new RA patients, 30 treated RA patients and 18 healthy controls were deceted by flow cytomery. All patients were hospitalised at the Department of Rheumatology, Second Hospital of Shanxi Medical University.Results:We found that the level of Tfr (CD3+CD4+CD25+CXCR5+FOP3+) percent(P=0.020), in the peripheral blood in RA patients were significantly decreased compared with healthy controls. The percent of Tfh (CD3+CD4+CXCR5+CD45RA-) (P=0.039)and Tfh17 (CD3+CD4+CXCR5+CD45RA-CXCR3-CCR6+) (P=0.000)were increased, but there are no statistical difference about Tfh1(CD3+CD4+CXCR5+CD45RA-CXCR3+CCR6-)(P=0.558) and Tfh2 (CD3+CD4+CXCR5+CD45RA-CXCR3-CCR6-) percent(P=0.079). We compared the above indicators between new and treated RA patients, and the results indicated that the Tfr(P=0.013),Tfh (P=0.002) and Tfh1(P=0.034) were significantly increased in the new RA patients compared to the treated RA patients, there were no differences between the two groups in Tfh2(P=0.419) and Tfh17 percent(P=0.124).Conclusion:Our results indicated that disorder of Tfr and Tfh subsets were involved in RA, restoring the Tfr/Tfh balance may be the potential therapeutic targets.Fig. 1.Comparison of Tfr, Tfh and its subsets(Tfh1 Tfh2 Tfh17) percent among the RA patients (n = 47) and healthy control group (n = 18) (*P < 0.05).Fig. 2.Comparison of Tfr,Tfh and its subsets(Tfh1 Tfh2 Tfh17) percent among the new RA patients (n = 17) and treated RA patients(n = 30) (*P < 0.05).References:[1]Deng J, Wei Y, Fonseca VR, Graca L, Yu D.T follicular helper cells and T follicular regulatory cells in rheumatic diseases[J].Nat Rev Rheumatol. 2019, 15(8):475-490.[2]Chen Liu, Dongwei Wang, Songsong Lu, et al.Increased Circulating Follicular Treg Cells Are Associated With Lower Levels of Autoantibodies in Patients With Rheumatoid Arthritis in Stable Remission.Arthritis Rheumatol. 2018, 70(5):711-721Disclosure of Interests:None declared

Application of ImageJ software for quantification of Hand Joint Space Narrowing in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 17 ◽  
Author(s):  
Nui Nguyen Minh ◽  
Nga Phi Thi Nguyen ◽  
Chau Nguyen Ngoc ◽  
Tien Tran Duy ◽  
Thong Nguyen Huy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Joint Space Width ◽  
Joint Space ◽  
Control Group ◽  
Healthy Control ◽  
The Mean ◽  
The Right ◽  
Imagej Software

Background: ImageJ software is used to quantify the joint space width (JSW) of hand and wrist in patients with rheumatoid arthritis (RA) as well as in the healthy control group. Method: Forty-one RA patients and 31 healthy controls are included in this study. All of 72 participants underwent digital radiography of the bilateral hand and wrist, then all the images were opened by ImageJ software to measure the width of wrist and hand joint space (total 2160 joints). Joint space narrowing (JSN) was defined if the width was less than the mean - 2SD of the control group. Result: The mean JSW of all sites of wrist and hand joints of RA patients was significantly reduced as compared to those in the control group (p<0.001). There were 37/41 (90.24%) RA patients who had JSN in at least one joint in hand or wrist. In total, 70.89% of joints on the right and 68.46% of joints on the left wrist and hand had JSN. Conclusion: ImageJ software was simple and convenient , which helps rheumatologists quantify the width of joint space for diagnosis and follow-up in RA patients.

Effect of MiR-21 on Regulating the Proliferation of Synovial Fibroblasts in Rheumatoid Arthritis

2020 ◽  
Vol 10 (7) ◽  
pp. 1052-1058
Author(s):  
Zhichao Li ◽  
Jin Wang ◽  
Jing Yang
Keyword(s):  
Rheumatoid Arthritis ◽  
Cell Proliferation ◽  
Cell Apoptosis ◽  
Mrna Level ◽  
Synovial Fibroblasts ◽  
Control Group ◽  
Spearman Correlation ◽  
Qrt Pcr ◽  
Relationship Of ◽  
The Relationship

Background: This study investigated whether miR-21 regulates the expression of STAT3 and affects FLS cells. Methods: MiR-21 and STAT3 mRNA level was assessed by qRT-PCR and STAT3 and p-STAT3 level was evaluated by Western blot. Spearman correlation was used to analyze the relationship between miR-21 and STAT3 mRNA expression in synovial tissue of RA patients. FLS cells were treated with IL-17A, and the cells without treatment was included as the control group. Under IL-17A treatment, FLS cells were divided into 2 groups: miR-NC group and miR-21 mimic group. MiR-21, STAT3, p-STAT3 expression were detected and compared. EdU staining was used to detect cell proliferation and flow cytometry was used to measure cell apoptosis. Results: There was a target relationship of miR-21 with STAT3 mRNA. IL-17A treatment significantly downregulated miR-21 in FLS cells, upregulated STAT3 and p-STAT3 and enhanced cell proliferation. Transfection of miR21 mimic significantly downregulated STAT3 and p-STAT3 in FLS cells, reduced cell proliferation and increased cell apoptosis. Conclusion: MiR-21 overexpression down-regulates STAT3, inhibits FLS cell proliferation and promotes apoptosis, indicating that it might be a therapeutic target for treating RA.

Amelioration of Extra-articular Effects Associated with Rheumatoid Arthritis Using Anti-arthritic Herbal Formulations

2020 ◽  
pp. 11-20
Author(s):  
Kemzi N. Elechi-Amadi ◽  
Ojoye N. Briggs ◽  
Boma H. Opusunju ◽  
Ebirien-Agana S. Bartimaeus ◽  
Edna O. Nwachuku
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Day Treatment ◽  
Positive Control ◽  
Negative Control ◽  
Control Group ◽  
Therapeutic Effects ◽  
Herbal Drug ◽  
Standard Drug ◽  
Herbal Formulations

Aim: This study investigated the ability of some herbal formulations to ameliorate extra-articular effects of some herbal formulations used in the management of rheumatoid arthritis in Nigeria. Methodology: Forty-nine (49) female albino Wistar rats were used for this study. They were divided into seven groups: A, B, C, D, E, F and G of seven rats each, with Group A serving as negative control while Group B was a positive control. Groups B, C, D, E, F and G were induced with rheumatoid arthritis by injecting 0.1 ml of Complete Freund's Adjuvant into the right hind paw of each rat. The rats were treated with the standard drug and herbal formulations respectively for 28 days as follows: Group C (treated with a standard drug, Celebrex), Group D (treated with the herbal drug, Jointeez), Group E (treated with a herbal drug, Arthropower), Group F (treated with combination therapy of Jointeez and Celebrex) and Group G (treated with combination therapy of Arthropower and Celebrex). At the end of the 28-day treatment period, the rats were anaesthetized with chloroform and sacrificed through puncture of the jugular vein. Five millilitres (5 ml) of blood samples were put into plain bottles for the analysis of biochemical parameters and 3 ml into K3EDTA bottles for haematological analysis. The lipid parameters were analysed using Mindray autoanalyzer while haematological parameters were determined using Sysmex haematology auto analyzer. Results: Total cholesterol (p<0.001), HDL (p=0.005) and LDL (p=0.004) were significantly reduced in the treated rats compared to the positive control group. Conversely, Packed Cell Volume (p<0.001) and Haemoglobin levels (p<0.001) were significantly reduced in the positive control rats compared to the treated rats. However, Total WBC count was significantly higher in the positive control rats than in the treated rats (p=0.001). The combination therapies used in this study did not offer a significantly different therapeutic advantage over the monotherapies used. The herbal formulations gave therapeutic effects on the extra-articular effects similar to that obtained from the orthodox drug used in this study.  Conclusion: The herbal formulations can be used as alternative regimens for rheumatoid arthritis. It is recommended that herbal formulations be considered for integration into our healthcare system for the management of rheumatoid arthritis.

scholarly journals The Evaluation of Some Biomarkers According to Rheumatoid Factor in Early Diagnosis of Rheumatoid Arthritis from Iraqi Patients

2020 ◽  
pp. 2196-2203
Author(s):  
Hind Jaber Hassoon ◽  
Walaa Esmail Jasim ◽  
Ahmed Abdul Hassan Abbas
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Diagnostic Value ◽  
Latex Agglutination ◽  
Control Group ◽  
Peptide Antigens ◽  
Healthy Control ◽  
Heterogeneous Nuclear Ribonucleoproteins ◽  
Serological Data ◽  
Inflammatory Autoimmune Disease

 Rheumatoid arthritis (RA) was a chronic inflammatory autoimmune disease for long-term that primarily affects small joints and leads to chronic inflammation in synovial. The aimed of the study to identify the relationships among some serological markers (antibodies to citrullinated protein/peptide antigens (ACPAs), anti-mutated citrullinated vimentin (anti-MCV), anti-carbamylated protein (Anti-Carp), anti- heterogeneous nuclear ribonucleoproteins (anti-hnRNP) and Glucose-6-phosphate isomerase (GPI)) and early diagnosis of RA. The study involved (60) Patients of newly diagnosis with RA that divided in to two subgroups (30 RF positive and 30 RF negative) groups and 30 subjects as healthy control group. The serological data from serum concentration of (ACPAs, Anti-MCV, Anti-Carp, Anti-hnRNP, G6PI) estimated by ELISA methods, RF estimated by latex agglutination kits. The results revealed that ACPAs, Anti-MCV, Anti-Carp, Anti-hnRNP, G6PI having a statistical significants at the mean±SD titer different between the two RF groups, a higher value among the refractory RA patients in comparison with the control group. Also effectively distinguishing RA patients groups for RF+ve and RF-ve with showed the sensitivity and specificity of, ACPAs (90.8% , 94.1%, and  88.2%, 86.6%); anti-MCV (66.7% , 33.0% and 70.0%, 70.2%); anti-CarP (76.7% , 90.0% and 93.3%, 78.5%); anti-hnRNP (74.9% , 61.9% and 71.4%, 70.9%) and GPI (77.3% , 76.7% and 84.4%, 80.1%) respectively. This study confirm the importance of measuring multiple serum biomarkers and their com­binations with high diagnostic value for RA and provide sup­port for the early diagnosis of RA.

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