Annexin A1 (Anxa1) Levels in Rheumatoid Arthritis: Association with Structural Joint Damage and Changes During Treatment

Background: Since rheumatoid arthritis is one of the most common diseases among the working-age population and significantly affects patients' quality of life, the study of this disease requires in-depth scientific research. The article presents the results of our own research dedicated to studying ANXA1 levels as a biomarker of immune inflammation and joint remodeling in patients with rheumatoid arthritis. Additionally, a significant correlation was demonstrated between ANXA1 levels and disease activity indicators, inflammatory markers, and clinical and laboratory criteria reflecting joint damage. Objective: The objective is to determine the role of ANXA1 in the progression of the immune inflammatory process in patients with rheumatoid arthritis, as well as its role in assessing structural changes in the joints, and to improve therapeutic and preventive measures. Methods: In our study, 108 patients with rheumatoid arthritis and 30 healthy individuals were examined. Based on the duration and stage of the disease, the patients were divided into early, established, and late stage groups, and the effect of ANXA1 levels on immune-inflammatory markers and early joint remodeling was determined. Results: The results of 52 weeks of treatment showed that the combination of basic therapy and baricitinib in patients with rheumatoid arthritis has high clinical and immunological efficacy. An increase in ANXA1 levels from 2.12 to 9.45 in the main group indicated the activation of its anti-inflammatory protective mechanisms, whereas in the control group, the increase in this indicator was relatively lower. At the same time, the DAS28 index, which reflects disease activity, significantly decreased from 5.08 to 2.7 in the main group, approaching a level of low activity or remission, while in the control group, this indicator remained at 3.5. Although the concentrations of TNF-α and IL-6, the main inflammatory cytokines, decreased in both groups, these changes were much more pronounced in the main group. Specifically, the TNF-α level decreased from 18.9 to 5.4, and the IL-6 level dropped from 14.8 to 5.4, indicating the effective suppression of the immune-inflammatory process. The obtained results demonstrated a close correlation between the restoration of ANXA1 expression, a decrease in cytokine production, and a significant reduction in disease activity in patients receiving baricitinib. This confirms the importance of baricitinib in effectively controlling the immune-inflammatory process and limiting disease progression in rheumatoid arthritis. Conclusion: It was found that in patients with RA, ANXA1 levels change in correlation with immune inflammatory markers (TNF-α and IL-6). A decrease in ANXA1 levels is accompanied by an increase in inflammatory cytokines and heightened disease activity. Furthermore, ANXA1 levels were associated with early remodeling processes in joint tissues, and their alteration manifested as an early sign of destructive changes. These findings confirm the potential of using ANXA1 as an important biomarker for assessing inflammatory acti.