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Vol. 18. Issue 8.
Pages 469-474 (October 2022)
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Vol. 18. Issue 8.
Pages 469-474 (October 2022)
Original Article
Anti-Carbamylated Protein Antibodies, Tumour Necrosis Factor Alpha and Insulin Resistance in Egyptian Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus
Anticuerpos anti-proteína carbamilada, factor de necrosis tumoral alfa y resistencia a la insulina en pacientes egipcios con artritis reumatoide y lupus eritematoso sistémico
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Mohamed Sherif El Hawarya, Sarah A. Hassana, Sahar Abd ELattyb, Noha M. Khalila,
Corresponding author
nohakhalil78@hotmail.com

Corresponding author.
a Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
b Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
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Abstract
Background

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are autoimmune diseases. Premature atherosclerosis and cardiovascular diseases are two of the most important complications of these diseases. Anti-carbamylated protein antibody (Anti-carP Ab) is one of the antibodies which was studied in RA and SLE. In our study, we studied the relation between anti-carP Ab, disease activity and insulin resistance in RA and SLE patients.

Methods

90Patients with SLE and RA were enrolled and subjected to history taking, clinical examination and assessment of disease activity using SLE disease activity index 2000 (SLEDAI-2K) scoring for SLE patients and disease activity score 28 (DAS28-ESR) for RA patients. Samples were examined for complete blood count (CBC), creatinine, inflammatory markers, Tumour necrosis factor alpha (TNF alpha), fasting insulin, fasting blood sugar (FBS), lipid profile and anti-carPAb. HOMA-IR (homeostasis model assessment for insulin resistance) was calculated.

Results

Patients with RA and SLE showed higher levels of anti-carPAb in comparison with healthy subjects (8.25ng/ml for RA, 7ng/ml for SLE and 0.6ng/ml for healthy subjects with p value <0.001). There was a positive correlation between anti-carPAb and disease activity of RA (p value <0.001) and a positive correlation between anti-carPAb and TNF alpha in RA. In SLE, there was no correlation of anti-carP Ab with disease activity while, HOMA-IR showed a positive correlation with nephritis (p value 0.04).

Conclusion

Anti-carP antibody is a marker of disease activity in RA patients and has high specificity for both RA and SLE detection.

Keywords:
Anti-carP Ab
SLE
RA
HOMA-IR
TNF alpha
Resumen
Antecedentes

La artritis reumatoide (AR) y el lupus eritematoso sistémico (LES) son enfermedades autoinmunes. La aterosclerosis prematura y las enfermedades cardiovasculares son 2 de las complicaciones más importantes de estas enfermedades. El anticuerpo anti-proteína carbamilada (Anti-carPAb) es uno de los anticuerpos que se estudió en AR y LES. En nuestro estudio analizamos la relación entre los Ac anti-carP, la actividad de la enfermedad y la resistencia a la insulina en pacientes con AR y LES.

Métodos

Se inscribieron 90 pacientes con LES y AR y se sometieron a la historia clínica, el examen clínico y la evaluación de la actividad de la enfermedad utilizando el índice de actividad de la enfermedad de LES 2000 (SLEDAI-2K) para los pacientes con LES y la calificación de actividad de la enfermedad 28 (DAS28-ESR) para los pacientes con AR. Las muestras se examinaron para hemograma completo, creatinina, marcadores inflamatorios, factor de necrosis tumoral alfa, insulina en ayunas, azúcar en sangre en ayunas, perfil de lípidos y anti-carPAb. Se calculó HOMA-IR (evaluación del modelo de homeostasis para la resistencia a la insulina).

Resultados

Los pacientes con AR y LES mostraron niveles más altos de anti-carP Ab encomparación con sujetos sanos (8,25ng/ml para AR, 7ng/ml para LES y 0,6ng/ml para sujetos sanos con un valor de p<0,001). Hubo una correlación positiva entre anti-carP Ab y la actividad de la enfermedad de la AR (valor de p<0,001) y una correlación positiva entre anti-carPAb y factor de necrosis tumoral alfa en la AR. En el LES no hubo correlación de anti-carPAb con la actividad de la enfermedad, mientras que HOMA-IR mostró una correlación positiva con la nefritis (valor de p=0,04).

Conclusión

El anticuerpo anti-carP es un marcador de la actividad de la enfermedad en pacientes con AR y tiene una alta especificidad para la detección de AR y LES.

Palabras clave:
Anti-carP Ab
SLE
RA
HOMA-IR
TNF

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