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Hammad R, Eldosoky MA, Lambert C, Sack U, Kujumdshiev S, Abd Elhamed SS, Elfishawi S, Mohamed EF, Kandeel EZ, Lotfy AW, Abulsoud MI, Abo-Elkheir OI, Hamdy NM, Farhoud H, Seddik M. Hsa-miR-21-5p reflects synovitis and tenosynovitis components of musculoskeletal ultrasonography Seven-joint scores in rheumatoid arthritis disease and predicts the disease flare. Pathol Res Pract 2024; 253:154960. [PMID: 38043193 DOI: 10.1016/j.prp.2023.154960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023]
Abstract
Rheumatoid arthritis (RA) is characterized by progressive joint destruction with subsequent serious disability. Objective biomarkers of RA course progression are lacking, which necessitates the discovery of activity indicators and predictors of the disease outcome. Musculoskeletal Ultrasound Seven-joint Score (MSUS7) is proposed as a reliable technique to evaluate radiographic RA progression. Homo sapiens-microRNA-21-5p (hsa-miR-21-5p) plays an important role during joint remodeling and the pro-inflammatory process driving RA progression. We aimed to evaluate plasma hsa-miR-21-5p as a noninvasive RA activity biomarker and to investigate if hsa-miR-21-5p is linked to MSUS7 components in the context of RA activity. This cross-sectional study included 71 RA patients classified into inactive (n = 36) and active (n = 35) groups according to the Disease Activity Score 28-joint count with ESR (DAS28-ESR). Joints were assessed by MSUS7. Gray-scale ultrasound (GSUS) and power Doppler ultrasound (PDUS) were used to rate the synovitis, tenosynovitis, and erosion in the joints. Plasma hsa-miR-21-5p expression was measured by real-time PCR. The absolute count of regulatory T cell (Treg) was calculated after Treg frequency was assessed by flow cytometry. Results: Hsa-miR-21 expression was significantly up-regulated in the active RA group with a median fold change of 51.6 in comparison to the inactive cases with a median fold change of 7.7 (p < 0.001). Hsa-miR-21-5p was positively correlated with DAS28-ESR, C reactive protein (CRP), and rheumatoid factor (r = 0.7, p < 0.001, r = 0. 0.6, p < 0.001, and r = 0.4, p = 0.002, respectively), while negatively correlated with Treg absolute count (r = -0.4, p < 0.001). Hsa-miR-21-5p levels were correlated with synovitis and tenosynovitis in GSUS (r = 0.4, p < 0.001, r = 0.3, p = 0.025, respectively) and in PDUS (r = 0.5, p < 0.001 and 0.4, p = 0.001, respectively). The hsa-miR-21-5p accurately distinguished RA activity [AUC 0.933, 94.3% sensitivity, and 86.1% specificity]. Logistic regression analysis revealed hsa-miR-21-5p as an independent predictor for RA flare (OR = 1.228, p = 0.004). Hsa-miR-21-5p was linked to synovitis and tenosynovitis components of the MSUS7. Up-regulated hsa-miR-21-5p can be utilized as a predictor for RA disease flare.
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Affiliation(s)
- Reham Hammad
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mona A Eldosoky
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Claude Lambert
- Cytometry Unit, Immunology Laboratory, Saint-Etienne University Hospital, France
| | - Ulrich Sack
- Institute for Clinical Immunology, Leipzig University Hospital, Germany
| | - Sandy Kujumdshiev
- Institute for Clinical Immunology, Leipzig University Hospital, Germany; German University of Applied Sciences for Health and Sports, Berlin, Germany
| | - Sally S Abd Elhamed
- Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Sally Elfishawi
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Z Kandeel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Abdel Wahab Lotfy
- Internal Medicine Department, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Mohamed I Abulsoud
- Orthopedic Surgery Department, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Omaima I Abo-Elkheir
- Community Medicine and Public Health Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Nadia M Hamdy
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Abbasia, Cairo, Egypt.
| | - Hesham Farhoud
- Orthopedic Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mahmoud Seddik
- Orthopedic Surgery Department, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt; Al-Azhar University for Post graduate and Research, Egypt
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