A study of immunological profile,disease characteristics and socioeconomic status of a population of rheumatoid arthritis patients in Sri Lanka |
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| Authors: | GK Rajapaksa V De Silva S Goonathilake I Athukorala LS Wijayarathna PV Udagama-Randeniya |
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| Affiliation: | 1. Department of Zoology, Faculty of Science, National Hospital, Sri Lanka;2. Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, National Hospital, Sri Lanka;3. Department of Rheumatology and Rehabilitation, National Hospital, Sri Lanka;1. Department of Microbiology & Immunology, The University of Texas Medical Branch, Galveston, TX 77555, USA;2. Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA;3. Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555, USA;4. Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX 77555, USA;5. Sealy Center for Vaccine Development, The University of Texas Medical Branch, Galveston, TX 77555 USA;1. Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA;2. Division of Pediatric Otolaryngology, Cohen Children''s Medical Center, New Hyde Park, NY, USA;3. Department of Otolaryngology – Head and Neck Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA;1. Senior Registrar in Rheumatology, National Hospital, Sri Lanka;2. Consultant Rheumatologist, National Hospital, Sri Lanka;1. Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;2. Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;3. Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;1. Medical Research Council Unit, The Gambia;2. Murdoch Children''s Research Institute, Melbourne, Australia;3. WHO Regional Office for Africa, Brazzaville, Congo;4. Academic Department of Paediatrics, Imperial College London, London W2 1NY, UK |
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| Abstract: | ObjectiveTo study the immunological profile, disease characteristics and socioeconomic status of a population of patients with rheumatoid arthritis (RA) in Sri Lanka.MethodsA case-control study was undertaken to characterize the immunoglobulin profiles of 105 RA and, age and gender matched osteoarthritis (OA) patients (n = 30) from the National Hospital, Sri Lanka. Healthy, non-arthritic individuals (n=30) served as controls. Sera were assayed for immunoglobulins [IgG, IgM, IgE and IgA isotypes] by establishing sandwich type ELISA. IgM, IgG and IgA rheumatoid factors (RFs) of 162RA patients were assayed by indirect ELISA. Disease characteristics and socioeconomic factors were accrued via an interviewer-administered questionnaire.ResultsHigher IgG, IgM, IgE, IgA and lower IgG1, IgG2 levels were observed in RA sera compared with controls (P < 0.05). Novel correlations between disease characteristics and immunoglobulins, as well as group-specific correlation matrices of immunoglobulins and RFs (P < 0.05) of seropositive and seronegative patients, were found. Higher IgM-RF and IgA-RF levels in seropositives and IgG-RF in seronegatives were evident compared with controls (P < 0.05). Immunoglobulin and RF profiles did not reflect gender disparity of RA (P > 0.05). Proportions of seropositives with nodules and erosions were significantly higher than seronegatives (P < 0.05). While IgM-RF and erosions positively correlated in the seropositives (P < 0.05), the seronegatives showed an inverse correlation between IgG-RF and erosions (P < 0.01). Familial clustering imposed a relative risk of 4.7 for developing seropositive RA.ConclusionsThis model study provides baseline information on pathogenetic aspects of RA in Sri Lanka, which may have implications for further research on management of the disease. |
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