Evaluation of CXCL2 and autophagy genes expression in rheumatoid arthritis patients and its relation to cardiovascular diseases

Background: Cardiovascular disease is among the most common comorbidity and the leading cause of mortality in patients with rheumatoid arthritis (RA). The aim of this study was to assess the levels of CXCL2 and autophagy genes such light chain (LC3) and beclin1 in patients with RA and how they relate to the clinical manifestations and carotid intimalemedial thickness. Patients and methods: This cross-sectional study included patients with RA. Sociodemographic characteristics and clinical and therapeutic data were recorded. Thorough medical and clinical examination was conducted to evaluate the disease status, including the number of swollen and tender joints, visual analog scale, and disease activity score 28. Approximately 5 ml of whole blood was collected from each participant, and CXCL2, LC3, and beclin1 expression levels were evaluated. The carotid intimaemedia thickness (CIMT) was assessed by a duplex ultrasound system. As a control group, 79 healthy individuals of matching age and sex were included. Results: A total of 79 patients with RA were included in the study, with mean ± SD age of 45.24 ± 10.07 years. Most of them were females (87.3%), and the median duration of RA was 7 years. Approximately 85% had positive rheumatoid factor, whereas 70.9% had positive anti-CCP antibody. CXCL2 and LC3 had a statistically significant positive correlation of medium strength (P 1⁄4 0.026). CXCL2 showed a significant positive correlation with presence of subcutaneous rheumatoid nodules, whereas there was a positive correlation of low strength between CXCL2 and systolic blood pressure, diastolic blood pressure, and health assessment questionnaire score. For LC3 gene expression, it was significantly correlated positively with presence of joint deformities and negatively with hypercholesterolemia. There was a statistically significant positive correlation of medium strength between LC3 and CIMT in those with disease duration more than or equal to 7 years after controlling (adjusting) for patient's age. Conclusions: CXCL2 and autophagy gene expression levels (LC3 and beclin1) are positively correlated with the clinical manifestations and CIMT in patients with RA. These genes may serve as predictors for cardiovascular disease in patients with RA.