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. 2023 Aug;11(8):e976.
doi: 10.1002/iid3.976.

Receptors expressions on peripheral lymphocytes and CD4+ CD183+ as a diagnostics biomarker for rheumatoid arthritis: A case-control study in Ghana

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Receptors expressions on peripheral lymphocytes and CD4+ CD183+ as a diagnostics biomarker for rheumatoid arthritis: A case-control study in Ghana

Samuel Asamoah Sakyi et al. Immun Inflamm Dis. 2023 Aug.

Abstract

Background: T cell receptors play important roles in the development and progression of rheumatoid arthritis (RA). Their involvement has been reported in inflammatory autoimmune diseases. However, their role in predicting RA is still under exploration. This study evaluated the expression of CD183 (CXCR3) receptors on T-cells and other relevant biomarkers for detecting RA and determine their relationship with disease activity.

Methods: This unmatched case-control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from the orthopedic units of Komfo Anokye Teaching Hospital (KATH), Kumasi and Korle-Bu Teaching Hospital (KBTH), Accra, Ghana. Sociodemographic data was obtained, and blood samples were also collected and processed for flow cytometric analysis. Statistical analyses were done using SPSS version 26.0 and R programming language. p < .05 was considered statistically significant.

Results: This study found a significant difference in age group (p < .0001), marital status (p = .0210), occupation (p = .0140), educational level (p = .0210) and religion (p = .0100) between RA patients and healthy controls. Moreover, hemoglobin level (p = .0010), waist circumference (p < .0001) and hip circumference (p = .0040) were significantly different between RA patients and controls. RA patients had significantly lower levels of CD4+ CD183+ compared with the control group (p < .001), and was positively correlated with DAS score (r = .0397, p = .789). In Receiver Operator Characteristics analysis, CD4+ CD183+ could significantly detect RA with a high area under the curve (AUC = 0.687, p = .018). At a cut-off of 0.082, CD4+ CD183+ was the best receptor biomarker for detecting RA with a sensitivity of 90.0%, specificity of 25.9%, a positive predictive value of 69.2%, and a negative predictive value of 58.3%.

Conclusion: CD4+ CD183+ best predict RA and is positively correlated with disease activity. CD4+ CD183+ could serve as diagnostics and disease-monitoring biomarker for RA; however, it demonstrates low specificity. Future studies should be directed on CD4+ CD183+ and other biomarkers to augment their diagnostics performances and routine management in RA.

Keywords: CD4+CD183+; chemokine receptors; diagnostics biomarker; disease activity score; receptor expression; rheumatoid arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic flowchart for recruitment of participants into the study. RA, rheumatoid arthritis.
Figure 2
Figure 2
Comparison between receptors expressions among rheumatoid arthritis patients and healthy controls; ns = p > .05, *p < .05, **p < .01, ***p < .001; p‐values computed by Mann‐Whitney U‐test; (A–D) represent density plot (A‐CD4+CD294+, B‐CD4+CD183+, C‐CD4+CD127+, D‐CD4+FOXP3+); (P–S) represent box and whisker plot (P‐CD4+CD294+, Q‐CD4+CD183+, R‐CD4+CD127+, S‐CD4+FOXP3+).
Figure 3
Figure 3
Correlation between receptors expressions and disease activity score (DAS) among rheumatoid arthritis patients, (A) CD4+CD294+, (B) CD4+CD183+, (C)‐CD4+CD127+, (D) CD4+FOXP3+.
Figure 4
Figure 4
The receiver operating characteristics (ROC) curves of CD4+CD294+, CD4+CD127+, CD4+ FOXP3+, and CD4+CD183+ for detecting rheumatoid arthritis, (A) CD4+CD127, CD4+CD294+, and CD4+FOXP3+; (B) CD4+CD183+.
Figure 5
Figure 5
Depicts the correlation between waist circumference (A–D), hip circumference (P–S) and receptor expressions among rheumatoid arthritis (RA) patients.

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