Interleukin-17 level in rheumatoid arthritis patients and its relation to disease activity : a clinical and ultrasound study

Abstract EN

Objective The aim of this study was to measure the level of interleukin-17A (IL-17A) in the serum and synovial fluid of patients with rheumatoid arthritis (RA) and its relation to disease activity.

Patients and methods A total of 100 patients suffering from RA were chosen from the outpatient clinic, Department of Physical Medicine and Rehabilitation, Menoufia University Hospital.

The patient group was divided into three subgroups-mild, moderate, and severe-according to the disease activity score.

All patients were subjected to clinical, laboratory, and ultrasound evaluation and to measurement of IL-17A in the serum and synovial fluid by means of the enzyme-linked immunosorbent assay technique.

Fifty healthy individuals were evaluated for IL-17A level in the blood, and served as the control group.

Results The present study revealed an increase in serum (P = 3.1) and synovial fluid (P = 5.2) IL-17A levels in RA patients with increased disease activity.

The ultrasound study showed an increase in serum IL-17A levels with increased erosion of the knee (P = 5.99) and wrist (P = 5.03).

There was an increase in serum IL-17A with increased effusion of the knee (P = 22.6) and wrist (P = 33.3).

There was an increase in serum IL-17A with increased synovial hypertrophy of the knee (P = 6.39), wrist (P = 12.23), and second metacarpophalangeal (MCP) (P = 53.34).

Finally, there was an increase in the blood IL-17A level, dryness of the eye (P = 3.8), dryness of the mouth (P = 3.2), and number of subcutaneous nodules (P = 2.5).

Conclusion In our study; the mean serum and synovial IL-17A levels were found in high titers in patients with disease activity, and with extra-articular manifestations like dry eyes, dry mouth, and subcutaneous nodules.

Also erosions, synovial hypertrophy, and effusions were found with significantly high titers of IL-17A, denoting its usefulness as a measurement tool for high disease activity and destruction.

Also targeting IL-17A may be useful as a treatment option for aggressive disease and for rheumatoid patients with poor prognosis.