Increased gene expression of CCR6 and RORγt in peripheral blood cells of rheumatoid arthritis patients and their correlation with anti‐cyclic citrullinated peptide and disease activity

Abstract Objectives The significance of T helper 17 (Th17) cells in the pathogenesis of rheumatoid arthritis (RA) has recently been demonstrated in many studies. Retinoic acid receptor‐related orphan receptor γt (RORγt) is a transcription factor that is specifically involved in the generation of Th17 cells. Besides, the chemokine receptor CCR6, the receptor for CCL20, is characteristically expressed by these cells. Considering the pivotal roles of Th17 cells in RA pathogenesis, in this study, we assessed the gene expression of CCR6 and RORγt in the peripheral blood leukocytes of new case RA patients. Also, we evaluated their association with anticyclic citrullinated peptide (anti‐CCP) antibodies and disease activity. Methods Forty‐five new case RA patients and 45 healthy persons have been recruited in this investigation. The gene expression of CCR6 and RORγt was evaluated by quantitative real‐time PCR (qRT‐PCR), and anti‐CCP antibodies plasma levels were measured using the enzyme‐linked immunosorbent assay (ELISA) technique. Disease activity was measured according to the disease activity score‐28 (DAS‐28) formula. Results The gene expression of CCR6 and RORγt increased remarkably in new case RA patients compared to healthy controls (p < .05 and p < .01, respectively). Moreover, there was a positive correlation between RORγt gene expression and parameters, including gene expression of CCR6 (p = .001, r = .461), plasma levels of CCL20 (p = .0009, r = .477), ESR (p = .004, r = .419), DAS‐28 (p = .006, r = .402), anti‐CCP (p = .019, r = .346), and RF (p = .001, r = .451). Also, CCR6 gene expression was positively associated with the DAS‐28 (p = .037, r = .310), plasma levels of anti‐CCP (p = .037, r = .312), and ESR (p = .029, r = .327). Conclusion Increased gene expression of CCR6 and RORγt in peripheral blood leukocytes of new case RA patients may contribute to the exacerbation and pathogenesis of RA

The development of anticyclic citrullinated peptide (anti‐CCP) antibody following severe COVID‐19

Abstract Objectives The dysregulated immune response is one of the cardinal features of severe coronavirus disease 2019 (COVID‐19). This study was conducted to clarify the occurrence of autoantibodies (AABs) associated with systemic autoimmune rheumatic diseases (SARDs) in hospitalized patients with a moderate, severe, and critical form of COVID‐19. Methods The serum samples obtained from 176 hospitalized COVID‐19 patients were investigated in this study, including patients with moderate (N = 90), severe (N = 50), and critical (N = 36) forms of COVID‐19. Also, the serum samples collected from healthy subjects before the COVID‐19 pandemic were used as controls (N = 176). The antinuclear antibodies (ANAs), antidouble‐stranded DNA (anti‐dsDNA), cytoplasmic‐anti neutrophil cytoplasmic antibody (c‐ANCA), perinuclear ANCA (p‐ANCA), antiphospholipid antibodies (aPLs), and anticyclic citrullinated peptide (anti‐CCP) occurrence was evaluated using a solid‐phase enzyme‐linked immunosorbent assay (ELISA). Results The results showed that the occurrence of ANAs, anti‐dsDNA, anti‐CCP, c‐ANCA, and p‐ANCA was significantly higher in the COVID‐19 patients compared to serum obtained from healthy subjects (p < .0001, p < .0001, p < .0001, p < .05, and p < .001, respectively). The positive number of anti‐CCP tests increased significantly in severe COVID‐19 compared to the moderate group (p < .01). Conclusion Our study further supports the development of autoantibodies related to systemic autoimmune rheumatologic diseases. To the best of our knowledge, this is the first study with a large sample size that reported the occurrence of anti‐CCP in a severe form of COVID‐19

Difference in the Cytomegalovirus-related Clinical Laboratory Findings Between Patients With Bone Marrow and Kidney Transplantations

Background: Despite close monitoring of transplant patients, Cytomegalovirus (CMV) infection has remained one of the most critical problems in transplantation. This study investigates the relationship between CMV viral load and clinical laboratory findings in transplant recipients. Materials And Methods: A total of 34 transplant recipients comprising 15 Kidney Transplant (KT) recipients and 19 Bone Marrow Transplant (BMT) recipients admitted to the Imam Reza Hospital in Kermanshah Province, Iran, were enrolled in this study. The CMV viral load was quantified by the real-time PCR technique. Results: The CMV viral load in KT recipients was significantly higher than in BMT recipients (P=0.03), and there was a positive association between the level of virus and the level of cyclosporine in the blood of patients (r=0.51, P=0.02). Besides, CMV viral load was positively correlated with WBC (r=0.32, P=0.04), urea (r=0.47, P=0.002), creatinine (r=0.39, P=0.01), aspartate aminotransferase (r=0.33, P=0.04), and lactate dehydrogenase (r=0.4, P=0.01). Also, it was negatively associated with albumin (r=-0.61, P<0.001), sodium (r=-0.4, P=0.01), and calcium levels (r=-0.46, P=0.003). There were also significant differences between KT and BMT recipients regarding the CMV-related clinical laboratory findings of urea (P=0.02), creatinine (P=0.001), uric acid (P=0.005), direct bilirubin (P=0.04), albumin (P=0.04), platelet (P<0.001), and sodium (P=0.04) levels. Conclusion: Based on present data, we conclude that despite careful monitoring of patients, infection with CMV is still one of the most important problems associated with organ transplantation, which is directly related to many laboratory findings