The sensitivity of Rheumatoid Arthritis patients for bacterial infection

Abstract

Rheumatoid arthritis (RA) is a complex autoimmune disease that affects 1-2% of the population worldwide. Multiple genetic risk factors and environmental triggers contribute to the pathogenesis of rheumatoid arthritis.  Microbial infection is thought to play an important role in the initiation and persistence of this disease, and one of the most important factors of virulence originating in the Enterobacter family is the specific Curli species A. The current study was conducted in Karbala governorate, (75) blood and urine samples were collected, (55) samples were collected from patients with rheumatoid arthritis RA and (20) samples were from healthy people, and the group with RA patients was divided into two groups, group (A) suffering from urinary tract infection,group(B)  uninfected urinary tract infection to determine the effect of bacterial infection on the level of (CD4 + Tcell, CD20 + Bcell, IL-17, IL-10),Use the bacterial sequencing (PCR) technique to determine the presence of CsgA in the bacteria.

Twenty three infections with different types of bacteria that infect the urinary tract were recorded in patients with rheumatoid arthritis. Bacterial isolates were identified using Viteck biochemistry test. The study showed a significant increase in the level of CD4 + T cells in patients with rheumatoid arthritis, whether they suffer from a bacterial infection (with the presence of the CsgA gene) or not, compared to the healthy group (P ≤ 0.001), as well as a significant increase in the level of these cells among those with rheumatoid arthritis.  Rheumatoid arthritis patients who had a bacterial infection compared to those with arthritis who did not suffer from a bacterial infection (P ≤ 0.05).  There is also a significant increase in the level of CD20 + Bcell cells in patients with rheumatoid arthritis (P ≤ 0.001) without bacterial infection compared to the healthy group. Finally, the results of the current study showed that there was a significant increase in the concentration of the anti-inflammatory cytokine IL-10 ( P ≤ 0.05) in  patients with rheumatoid arthritis  bacterial disease compared to patients without bacterial diseaseas well as compared with the healthy group.the pro-inflammatory cytokine IL-17 did not show significant differences with healthy controls and all groups of patients. Conclusion that bacterial infection (UTI) in patients with rheumatoid arthritis, especially bacteria that express CsgA gene, activate the adaptive immune response (B and T cells). The current language of the study is to know the sensitivity of rheumatoid arthritis to entero bacter infection and to identify the effect of the Csg A gene on some immune factors.