Hematological Parameters and Their Relationship to Interleukin-6 in Rheumatoid Arthritis Men

Zainab Qasim Muhammad Al-Yasiri

Zainab Qasim Muhammad Al-Yasiri Dept. of Biology, College of Education for Women, University of Shatrah, Iraq

Keywords: Rhematoid arthritis, , interleukin-6, hematological parameters

Abstract

This study was intended to look at the relationship between Hematological parameters and IL-6 in men with rheumatoid arthritis in Thi Qar province/Iraq, as well as to study the effect of age, body mass index and blood groups on blood parameters. The study included 100 men, 60 of whom were RA patients and 40 healthy men as a group in control. Their ages were in the range of 45-75 years. Blood samples were used to examine ABO blood groups and complete blood count (CBC), while serum was used to measure IL-6. The samples were divided into two groups according to age group, three groups according to BMI and eight groups according to blood groups.

According to the findings, IL-6 was considerably elevated (P<0.05) in RA patients compared to the control group. In contrast, the Hematological parameters examination indicated that the total WBC was greatly raised (P<0.05) in patients, while differential count of WBC was significantly increased in neutrophils and eosinophils, while the lymphocytes were dramatically reduced (P<0.05) in patients with RA as opposed to the control group .On other hand, the red blood cell count indicated that RBC, HGB, HCT and HGB, MCV, MCH, MCHC and HGB/HCT were substantially lower in patients (P<0.05). In contrast, platelet parameters PLT, PDW and PCT were much higher (P<0.05) in patients, except for MPV, which was significantly decreased in RA patients compared to the control group.When comparing the Hematological parameters of RA patients according to age group, MPV and PDW were considerably higher (P<0.05) in the second category of age GII (60-75) years as opposed to the first age category GI (45-60) years. On the other hand, the comparison between patients according to BMI indicated that the same two parameters above were significantly increased (P<0.05) in the third group GIII (Class I obesity) compared to the first group GI (Normal weight). In contrast, the comparison between RA patients according to blood groups showed no significant differences (P>0.05) in all Hematological parameters. Blood group O recorded the highest incidence of RA while group AB recorded the lowest incidence.

The results of the correlation analysis indicated a significant positive correlation between IL-6 and each of Neu, PLT, PDW, PCT and PLT/Lym ratio while IL-6 recorded a significant negative correlation with HGB, HCT, MCV, MCHC and HGB/HCT ratio.

References

1. Alivernini, S., Firestein, G. S., & McInnes, I. B. (2022). The pathogenesis of rheumatoid arthritis. Immunity. sciencedirect.com.
2. Aliyu, M., Zohora, F. T., Anka, A. U., Ali, K., Maleknia, S., Saffarioun, M., & Azizi, G. (2022). Interleukin-6 cytokine: An overview of the immune regulation, immune dysregulation, and therapeutic approach. International immunopharmacology, 111, 109130. [HTML]
3. Atwa E.T., Omar H.M., Amin A., Hammad M. Red Cell Distribution Width and Mean Platelet Volume in Rheumatoid Arthritis Patients: Its Association with Disease Activity. Reumatol. Clínica (Engl. Ed.) 2022;18:399–405. doi: 10.1016/J.REUMAE.2021.04.011. [DOI] [PubMed] [Google Scholar]
4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35046715.
5. Bakker AJ, Mücke M.(2007). Gammopathy interference in clinical chemistry assays: mechanisms, detection and prevention. Clin Chem Lab Med 2007;45(9):1240-1243.
6. Baughman, R.P.; Cremers, J.P; Harmon, M.; Lower, E.E; Drent, M. Methotrexate in sarcoidosis: hematologic and hepatic toxicity encountered in a large cohort over a six year period. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases 2020, 37(3), e2020001. DOI: https://doi.org/10.36141/svdld.v37i3.9362.
7. Blanter, M., Gouwy, M., & Struyf, S. (2021). Studying neutrophil function in vitro: cell models and environmental factors. Journal of inflammation research. tandfonline.com.
8. Brecher M. (2002) Technical Manual. (ed) 14th ed. Bethesda, MD: American Association of Blood Banks, 2002.
9. Conforti, A., Di Cola, I., Pavlych, V., Ruscitti, P., Berardicurti, O., Ursini, F., ... & Cipriani, P. (2021). Beyond the joints, the extra-articular manifestations in rheumatoid arthritis. Autoimmunity reviews, 20(2), 102735. [HTML]
10. Coutant F, and Miossec P. (2020) Evolving concepts of the pathogenesis of rheumatoid arthritis with focus on the early and late stages. Curr. Opin. Rheumatol., 32, 57–63.
11. Favalli, E. G. (2020). Understanding the role of interleukin-6 (IL-6) in the joint and beyond: a comprehensive review of IL-6 inhibition for the management of rheumatoid arthritis. Rheumatology and therapy. springer.com
12. Fraenkel, L., Bathon, J. M., England, B. R., St. Clair, E. W., Arayssi, T., Carandang, K., ... & Akl, E. A. (2021). 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis & Rheumatology, 73(7), 1108-1123. nih.gov.
13. Guo, F., He, Y., Fan, Y., Du, Z., Sun, H., Feng, Z., ... & Xiong, T. (2021). G-CSF and IL-6 may be involved in formation of endometriosis lesions by increasing the expression of angiogenic factors in neutrophils. Molecular human reproduction, 27(11), gaab064. researchgate.net.
14. Holers, V. M., Kuhn, K. A., Demoruelle, M. K., Norris, J. M., Firestein, G. S., James, E. A., & Deane, K. D. (2022). Mechanism-driven strategies for prevention of rheumatoid arthritis. Rheumatology & autoimmunity, 2(03), 109-119. mednexus.org
15. Khaled S. A, Eldin E. N, Makarem Y S and Mahmoud H. F (2020).Value of Platelet Distribution Width and Mean Platelet Volume in Disease Activity Score of Rheumatoid Arthritis. Journal of Inﬂammation Research. September 2020 13: 595-606. DOI:10.2147/JIR.S265811, Dovepress open access to scientiﬁc and medical research.
16. Klion AD, Ackerman SJ, Bochner BS. Contributions of Eosinophils to Human Health and Disease. Annu Rev Pathol (2020) 15:179–209. doi: 10.1146/annurev-pathmechdis-012419-032756 [DOI] [PMC free article] [PubMed] [Google Scholar]
17. Kondo, N., Kuroda, T., & Kobayashi, D. (2021). Cytokine networks in the pathogenesis of rheumatoid arthritis. International journal of molecular sciences, 22(20), 10922. mdpi.com
18. Koster, D., Egedal, J. H., Lomholt, S., Hvid, M., Jakobsen, M. R., Müller-Ladner, U., & Nielsen, M. A. (2021). Phenotypic and functional characterization of synovial fluid-derived fibroblast-like synoviocytes in rheumatoid arthritis. Scientific Reports, 11(1), 22168. nature.com.
19. Kristyanto, H., Blomberg, N. J., Slot, L. M., van der Voort, E. I., Kerkman, P. F., Bakker, A., & Scherer, H. U. (2020). Persistently activated, proliferative memory autoreactive B cells promote inflammation in rheumatoid arthritis. Science translational medicine, 12(570), eaaz5327. nih.gov.
20. Lajqi, T., Braun, M., Kranig, S. A., Frommhold, D., Pöschl, J., & Hudalla, H. (2021). LPS induces opposing memory-like inflammatory responses in mouse bone marrow neutrophils. International journal of molecular sciences, 22(18), 9803. mdpi.com.
21. Li, R., Ye, J. J., Gan, L., Zhang, M., Sun, D., Li, Y., ... & Chang, P. (2024). Traumatic inflammatory response: pathophysiological role and clinical value of cytokines. European Journal of Trauma and Emergency Surgery, 50(4), 1313-1330. springer.com.
22. Mahmoud, D. E., Kaabachi, W., Sassi, N., Tarhouni, L., Rekik, S., Jemmali, S., & Laadhar, L. (2022). The synovial fluid fibroblast-like synoviocyte: A long-neglected piece in the puzzle of rheumatoid arthritis pathogenesis. Frontiers in Immunology, 13, 942417. frontiersin.org.
23. Michalaki, E., Nepiyushchikh, Z., Rudd, J. M., Bernard, F. C., Mukherjee, A., McKinney, J. M., & Dixon, J. B. (2022). Effect of human synovial fluid from osteoarthritis patients and healthy individuals on lymphatic contractile activity. Journal of biomechanical engineering, 144(7), 071012. asme.org.
24. Muhammed, D.S., Polus,R.K. and Mohammed, N.S. (2024). Relationship between Different Hematological Parameters and Disease Activity in Patients with Rheumatoid Arthritis. Advanced Medical Journal, Vol.9, No.1, P.46-55, 2024 .DOI: https://doi.org/10.56056/amj.2024.236.
25. Ni, C., Gao, S., Zheng, Y., Liu, P., & Zhai…, Y. (2021). Annexin A1 attenuates neutrophil migration and IL-6 expression through Fpr2 in a mouse model of Streptococcus suis-induced meningitis. Infection and asm.org.
26. Nikiphorou E., De Lusignan S., Mallen C., Khavandi K., Roberts J., Buckley C.D., Galloway J., Raza K. Haematological Abnormalities in New-Onset Rheumatoid Arthritis and Risk of Common Infections: A Population-Based Study. Rheumatology. 2020;59:997–1005. doi: 10.1093/rheumatology/kez344. [DOI] [PMC free article] [PubMed] [Google Scholar].
27. Pereckova J, Martiniakova S, Payer J et al., (2022): Analysis of hematological parameters in rheumatoid arthritis patients receiving biological therapy: contribution to prevention of avoidable hematological complications. EXCLI Journal, 21:580-594.
28. Scherer, H. U., van der Woude, D., & Toes, R. E. (2022). From risk to chronicity: evolution of autoreactive B cell and antibody responses in rheumatoid arthritis. Nature Reviews Rheumatology, 18(7), 371-383. [HTML].
29. Scherer, H. U., van der Woude, D., & Toes, R. E. (2022). From risk to chronicity: evolution of autoreactive B cell and antibody responses in rheumatoid arthritis. Nature Reviews Rheumatology, 18(7), 371-383. [HTML].
30. Sebba, A. (2021). Pain: a review of interleukin-6 and its roles in the pain of rheumatoid arthritis. Open access rheumatology: research and reviews. tandfonline.com.
31. Shakil M, Saleem DM, Zafar A, Ali A, Raziq M, Shams S. Clinical and hematological parameters in patients of Rheumatoid arthritis in a tertiary care hospital. Rawal Med. J. 2021; 46(1):45. Available from: https://www.rmj.org.pk/fulltext/27-1588711248.pdf.
32. Sierra M G, Romo-Cordero A, Quevedo-Abeledo J C, et al., (2023). Mean Platelet Volume in a Series of 315 Patients with Rheumatoid Arthritis: Relationship with Disease Characteristics, including Subclinical Atherosclerosis and Cardiovascular Comorbidity. Diagnostics 2023, 13(20), 3208; https://doi.org/10.3390/diagnostics13203208.
33. Singh, A., Behl, T., Sehgal, A., Singh, S., Sharma, N., Naved, T., & Bungau, S. (2021). Mechanistic insights into the role of B cells in rheumatoid arthritis. International Immunopharmacology, 99, 108078. [HTML].
34. Warjukar, P. R., Mohabey, A. V., Jain, P. B., & Bandre, G. R. (2024). Decoding the correlation between inflammatory response marker interleukin-6 (IL-6) and C-reactive protein (CRP) with disease activity in rheumatoid arthritis. Cureus. nih.gov.
35. Xiao, Y., Cong, M., Li, J., He, D., Wu, Q., Tian, P., & Hu, G. (2021). Cathepsin C promotes breast cancer lung metastasis by modulating neutrophil infiltration and neutrophil extracellular trap formation. Cancer cell, 39(3), 423-437. cell.com.
36. Xue L, Tao L, Sun H, et al., Association Between Blood PLT and RBC Related Indices and Disease Activity in Patients with Rheumatoid Arthritis. Int J Gen Med. 2022; 15:573-81.
37. Yoo, B. W., Song, J. J., Park, Y. B., & Lee, S. W. (2022). 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease by Wallace et al., Annals of the Rheumatic Diseases, 81(9), e179-e179. bmj.com.