Association Between Interleukin-4 and Chemokine CCL-21 Levels With the Pathogenesis of Rheumatoid Arthritis in Iraqi Women

Background: Approximately 0.5%–1% of the global population is impacted by rheumatoid arthritis, with the prevalence adjusted for age and the rates of disability-adjusted life years showing an increase with age and being higher in female. The susceptibility to RA is notably higher in women, who are two to three times more likely to acquire the condition compared to men. The study highlights the importance of anti-inflammatory and inflammatory levels in treating rheumatoid arthritis in Iraqi women, emphasizing the need for balance in autoimmune disorders. Objectives: The presented study aimed the anti-inflammatory agents like IL-4 and chemokine CCL-21 marker on the progression and pathogenesis of rheumatoid arthritis in women from Iraq. Materials and Methods: A case-control study involving 96 female subjects aged 30-70 years, who were divided into two groups: 59 subject with RA patients and 37 healthy individuals as a control. Serum IL-4 and CCL-21 levels were measured using an ELISA technique Results: The observed results indicated a significant increased in mean ± SD of both IL-4 and CCL-21 levels in sera of Iraqi women with RA as compared with apparently healthy controls group, P value ≥ 0.001) respectively. The receiver operating curve (ROC) analysis for IL-4 and CCL-21 showed that the CCL-21 levels indicate a (sensitivity = 89.9 %, specificity 90%) AUC = 66.4205 while IL-4 levels indicate (sensitivity = 94.9%, specificity 93.7%) AUC = 10.6489. Conclusion: Anti-inflammatory levels play an important role in the pathophysiology of RA, so IL-4 and inflammation can be considered biomarkers for evaluating RA. Maintaining a balance between anti-inflammatory and inflammatory status is essential in treating rheumatoid arthritis and other autoimmune diseases.