Evaluating TGF-β1 alongside RF, Anti-CCP and ESR for Improved Diagnosis of Rheumatoid Arthritis

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

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Department of Medical Microbiology , College of Medicine, University of Karbala, Karbala, Iraq

Abstract

Background: Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis and is characterized by a chronic, systemic autoimmune response that leads to symmetrical joint inflammation. Accurate diagnosis and monitoring of disease progression are critical for effective management. Objective: This study aimed to evaluate serum levels of transforming growth factor-beta1 (TGF-β1), rheumatoid factor (RF), anti-cyclic citrullinated peptide (ACCP) antibodies, erythrocyte sedimentation rate (ESR), and body mass index (BMI) in patients with RA compared to healthy controls, to assess their diagnostic and prognostic value. Methods: A total of 90 participants were enrolled in this case-control study conducted in Kerbala province from November 2024 to March 2025. The study included 45 patients diagnosed with RA and 45 apparently healthy individuals as controls, aged between 32 and 70 years. Demographic data and family history were collected, and BMI was calculated. Serum levels of TGF-β1, RF, ACCP, and ESR were measured and analyzed statistically. Results: RA was significantly more prevalent among females (89%) than males (11%). Patients with RA had significantly elevated levels of TGF-β1, RF, ACCP, and ESR compared to healthy controls (p < 0.05). ROC curve analysis for TGF-β1 revealed a sensitivity of 91.1%, specificity of 89.9%, and an area under the curve (AUC) of 0.96, indicating strong diagnostic performance. Additionally, higher BMI was associated with increased disease severity. Conclusions: TGF-β1, along with RF, ACCP, and ESR, shows significant potential as a diagnostic and monitoring tool for RA. The findings support the inclusion of TGF-β1 as a supplementary biomarker in RA assessment. Furthermore, elevated BMI may contribute to worse disease outcomes, highlighting the importance of weight management in RA patients.

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