Influence of circulating complement linked to immune complexes in predictive models of clinical evolution in rheumatoid arthritis
Keywords:
rheumatoid arthritis, circulating immune complexes, complement proteins, clinical activity, sex, smoking.Abstract
Introduction: The complement system is a main component of the immune system and plays a central role in many protective immune processes. However, inappropriate complement activation underlies on the pathogenesis of autoimmune diseases, such as rheumatoid arthritis.
Objective: To identify the influence of circulating immune complexes, linked to C1q and C3d, in predictive models of clinical evolution, associated with autoantibodies, sex and smoking in rheumatoid arthritis.
Methods: A 6-month prospective longitudinal study was conducted with 60 Cuban patients with rheumatoid arthritis first treated with methotrexate. The erythrocyte sedimentation rate and the indicator of clinical disease activity were determined. Circulating immune complexes with complement proteins C1q and C3d, anti-citrullinated protein antibodies and rheumatoid factor were determined by enzyme-linked immunosorbent assays.
Results: The decrease in clinical activity observed during treatment corresponds to the decrease in concentrations of circulating immune complex with C1q and C3d proteins (p <0.0001). Multivariate analysis is demonstrate the influence of circulating immune complexes formed by C1q and C3d proteins determined at the start of treatment on the clinical activity of patients at 6 months of treatment in various prediction models (p <0.0001).
Conclusion: Circulating immune complexes formed by proteins C1q and C3d predict the clinical course of patients with rheumatoid arthritis, associated with autoantibodies, sex and smoking.
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