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Abstract
In the last decade, there was a lot of successful research in the field of cytokine expression and regulation. It has become clear that pro- and anti-inflammatory cytokines, derived predominantly from cells of macrophage lineage and other inflammatory cells, play a major role in the initiation and perpetuation of the chronic inflammatory process in the RA synovial membrane. It has become clear in the last few years that T cell-derived cytokines expressed preferentially by Th1 cells contribute to joint destruction and inflammation in RA. However, products from Th2 cells may be protective (Scheinecker and Smolen, 2005).
The purpose of this work was to study functional T-cell activation and cytokine production in the synovial fluid mononuclear cells (SFMC) and peripheral blood mononuclear cells (PBMC) :(interferon–gamma (IFN-), interleukin–4 (IL-4), and tumor necrosis factor-α (TNF-α); in patients with rheumatoid arthritis (RA), and other inflammatory arthritis and to correlate the results with clinical and laboratory parameters of disease activity.
The study included 60 subjects. They were classified into four groups:
Group I: It includes 20 patients with RA diagnosed according to ACR criteria (1987).
Group II: It includes 10 patients with juvenile rheumatoid arthritis JCA diagnosed according to ACR criteria (1986).
Group III: It includes 10 patients with AS diagnosed according to Modified New York criteria (1984).
Group IV:
Group IV a: included 10 patients with knee osteoarthritis (OA) diagnosed according to Altman criteria of classification (1986)
Group IV b: included 10 normal individuals as a control group.
All patients were chosen from the out patients clinic and inpatients of Rheumatology and Rehabilitation Department of Zagazig University Hospitals
All patients will subjected to
1. Full history taking.
2. Thorough general examination.
3. Loco motor system examination.
4. Laboratory investigations:
• Complete blood picture (CBC).
• Erythrocyte sedimentation rate (ESR) by westergreen method.
• C reactive protein (CRP).
• Rheumatoid factor (RF) by latex fixation test.
• Estimation interferon – gamma (IFN-), interleukin– 4 (IL-4), and tumor necrosis factor- α (TNF-α); produced in synovial fluid mononuclear cells (SFMC) and peripheral blood mononuclear cells (PBMC) using ELISA and culture.
5. Plain X ray on:
• Plain X- ray on both hands antroposterior view in RA and JCA patients.
• Plain X- ray antroposterior and lateral view of lumbar spine and lateral view of cervical spine and pelvic radiograph including sacroiliac joints and hips in AS patients.
• Plain X- ray antro-posterior and lateral view of knee joint in OA patients.