Immunochimie et immunopathologie

Introduction: The development of rheumatoid arthritis (RA) is associated with the formation of a wide spectrum of autoantibodies, including rheumatoid factors (RFs) and anti-citrullinated protein antibodies (ACPAs). A family of autoantibodies that recognize carbamylated proteins, Anti-CarP antibodies can be detected in sera of RA patients. The aim of the present study was to evaluate the role of anticarbamylated protein antibody (Anti-CarP antibodies) in diagnosis of seronegative (Negative RF and Negative ACCP) RA patients, in monitoring the severity of inflammation and degree of associated joint damage.

Methodology: Our study included 60 patients with seronegative RA (4 males and 56 females), their ages ranged between 29 and 70 years with a mean age of 48.5 ± 11.8 years, and 20 healthy controls of matched age and sex. Anti-CarP antibodies concentrations were measured by enzyme-linked immune-sorbent assay (ELISA).

Results: ACarPA was statistically significant increase in RA group compared to control group with no statistical significant differences between different RA groups. There was no statistical correlation between ACarPA and inflammatory markers (CRP and ESR). ACarPA had high diagnostic performance in differentiating RA from control and mild RA from control. There was no statistically significant difference in ACarPA between cases with or without osteolytic lesions in various RA studied groups.

Conclusion: Serum Anti-CarP Ab is a significant serological marker in sero-negative RA patients that has the potential to differentiate RA patients from control group.

Background: Regulatory T cells (Tregs) have a fundamental job in keeping up a harmony between forestalling immunopathology and enabling the insusceptible reaction to clear infections, in HCV infection, elevation of Tregs may cause insistent HCV infection.

Objective: The current work aimed to clarify the immunomodulatory role of CD4+ CD25+ Foxp3+ Tregs in chronic hepatitis C (CHC) patients.

Subjects and methods: This study incorporated two groups: 50 patients with chronic HCV infection of different classes of Child-Pugh classification (Child A, B and C) and control group; 25 healthy subjects. All patients were exposed to full history taking and finish clinical examination, as well as routine lab analysis including CBC, AST, ALT, ALP, GGT, PT, INR, blood urea, serum creatinine, ANA. HCV-Abs was measured for both patients and controls groups. Viral load was determined for patients group by HCV-RNA PCR. Immunophenotyping of CD4⁺ CD25⁺ FoxP3+ regulatory Treg cells were performed by flow Cytometry for patients and controls groups.

Results: There was expansion of CD4⁺25⁺ FOXP3⁺ Treg lymphocytes in CHC patients compared with controls with significant difference. Furthermore, there was a highly significant decline in the average of CD4⁺25⁺ FOXP3⁺ Treg lymphocytes amongst the 3 different classes of Child-Pugh classification of CHC patients on relating to the control. There were significant correlations between CD4⁺25⁺ FOXP3⁺Treg lymphocytes and liver fibrosis.

Conclusion: There is marked increased level of CD4⁺25⁺ FOXP3⁺Treg lymphocytes among CHC patients, in addition to, the 3 different classes of Child-Pugh classification. This might confirm the immunomodulatory role by CD4⁺25⁺ FOXP3⁺Treg during chronic HCV infection that it might contribute to the immune response failure.