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Our objective was to analyse the relationship between circulating cytokines, autoantibodies, acute phase reactants, and disease activity in DMARDs-naïve rheumatoid arthritis (RA) patients ( n  = 140). All cytokines were significantly higher in the RA cohort than in healthy controls. Moderate-to-strong positive intercorrelations were observed between Th1/Th2/macrophage/fibroblast-derived cytokines. RF correlated significantly with IL-1 β , IL-2, IL-4, IL-10, IL-12, G-CSF, GM-CSF, IFN- γ , and TNF ( P  < .0001), and aCCP and aMCV with IL-1 β , IL-2, IL-4, and IL-10 ( P  < .0002), while IL-6 correlated best with the acute phase reactants, CRP, and SAA ( P  < .0001). In patients with a DAS28 score of ≥5.1, IFN- γ , IL-1 β , IL-1Ra, TNF, GM-CSF, and VEGF were significantly correlated ( P  < .04–.001) with high disease activity (HDA). Circulating cytokines in RA reflect a multifaceted increase in immune reactivity encompassing Th1 and Th2 cells, monocytes/macrophages, and synovial fibroblasts, underscored by strong correlations between these cytokines, as well as their relationships with RF, aCCP, and aMCV, with some cytokines showing promise as biomarkers of HDA.

mediators of inflammation

Circulating Cytokine Profiles and Their Relationships with Autoantibodies, Acute Phase Reactants, and Disease Activity in Patients with Rheumatoid Arthritis