The Effect of Disease-modifying Antirheumatic Drugs (DMARDs) on the Expression and Methylation Status of the FOXO1 gene in Newly Diagnosed Patients with Rheumatoid Arthritis

Background: The expression of forkhead box O (FOXO) was found to be connected with developing rheumatoid arthritis (RA), an inflammatory autoimmune disorder. The current study is intended to assess the expression and methylation status of the FOXO1 gene in individuals with recently diagnosed RA, before and after the administration of customary disease-modifying antirheumatic drugs (DMARDs). Methods: Twenty participants were investigated in this study. The assessment of the FOXO1 gene expression in peripheral blood was done by real-time PCR, and the status of FOXO1 promoter methylation was ascertained via quantitative methylation-specific PCR (Q-MSP) before and after the administration of DMARDs for six months. Results: Following DMARDs treatment, the study discovered a decrease in FOXO1 gene expression. However, the decline did not meet the criteria for statistically meaningful (P = 0.087). The expression of the FOXO1 gene was positively correlated with RA disease activity pre- and post-treatment with DMARDs (P = 0.009, r = 0.567 and P = 0.001, r = 0.656, respectively). Moreover, the study showed no alterations in the amount of DNA methylation of the FOXO1 promoter in newly diagnosed RA patients who had not yet received DMARDs, as compared to DMARDs-treated RA patients. Conclusion: Altogether, this study suggests that DMARDs treatment may reduce FOXO1 gene expression, potentially helping to alleviate the pro-inflammatory effects associated with this gene.