Exploring the Roles of Pro-Inflammatory TNF-α and Anti-Inflammatory IL-35 Cytokines in the Pathogenesis of Rheumatoid Arthritis among Patients in Baghdad, Iraq

Document Type : New and original researches in the field of Microbiology.

Authors

1 Deptartment of Biology, Faculty of Science, Erciyes University, Turkey

2 Department of Clinical Laboratory Sciences, College of Pharmacy, Tikrit University, Tikrit, Iraq

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, immune-mediated inflammatory disease characterized by synovitis, particularly affecting the small joints of the hands and feet. Tumor necrosis factor-alpha (TNF-α), a pro-inflammatory cytokine, plays a critical role in the etiology and pathogenesis of RA. Objectives: To evaluate the levels of TNF-α and IL-35, along with various clinical indicators, to assess their potential in predicting disease outcomes in Iraqi patients with RA. Methodology: A total of 125 participants were enrolled in this study, including 100 patients diagnosed with RA and 25 healthy controls. The study was conducted at the Rheumatology Consultation Clinic, Baghdad Teaching Hospital, Medical City, between September 2024 and March 2025. Participants ranged in age from 15 to 70 years. Serum levels of the pro-inflammatory cytokine TNF-α and the anti-inflammatory cytokine IL-35 were measured using the ELISA technique. Results: The study found no statistically significant differences in TNF-α concentration among RA patients based on disease duration or family history of RA. However, TNF-α levels were significantly higher in RA patients compared to healthy controls (p=0.0055 and p<0.0001, respectively). Furthermore, female patients exhibited significantly higher TNF-α levels than males (p = 0.0256), whereas the difference in males was not significant (p=0.6200). TNF-α concentration were also significantly higher in older patients compared to younger individuals. Regarding IL-35, its concentration was significantly decreased in both male and female RA patients compared to healthy individuals (p < 0.0001). Conclusion: The findings suggest a clear distinction between the roles of pro- and anti-inflammatory cytokines in RA. The decreased levels of IL-35 in RA patients indicate its potential involvement in joint inflammation and damage. IL-35 may contribute to disease progression by modulating immune responses affecting bone and joint health.

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