Rheumatoid arthritis (RA) is a persistent autoimmune disease stimulated by a sophisticated system of proinflammatory cytokines such as TNF-α and IL -17. They contribute significantly to the maintenance of inflammation and mediation of joint damage. The current study aimed to examine the relationship between serum concentrations of TNF-α, IL-17 A, and IL-17 F and disease activity in Yemeni RA patients. A case-control study was carried out on 101 RA patients and 80 healthy controls (HCs) matched for age and sex. The serum concentration of TNF-α, IL-17 A, and IL-17 F was determined through an enzyme-linked immunosorbent assay (ELISA). Other hematological, inflammatory parameters and serological tests were also assessed. TNF-α, IL-17 A and IL-17 F serum levels were significantly elevated in RA patients than in HCs (P < 0.001) and had a positive correlation with disease activity in RA groups (P < 0.001). Furthermore, a significant positive correlation between levels of TNF-α, IL-17 A, and IL-17 F and the DAS28. The ROC analysis revealed that all the three cytokines TNF-α, IL-17 A, and IL-17 F were effective in distinguishing between RA patients and HCs, with TNF-α having the highest diagnostic accuracy. To define moderate to high disease activity, IL-17 A demonstrated the best individual quality, whereas TNF-α and IL-17 F demonstrated moderate quality. Interaction of the cytokines improved the diagnostic value as both TNF-α and IL-17 A combination and triple combination of TNF-α, IL-17 A and IL17F which supports the benefits of multiplex cytokine testing in RA activity testing as well as discrimination of moderate to high activity RA.
Saleh et al. (Mon,) studied this question.