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Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis

Immunoglobulin (Ig) G4 accounts for 4–6% of the total IgG in a healthy human. Several evidence-based studies have suggested that the level of IgG4 is significantly elevated in autoimmune diseases, including rheumatoid arthritis (RA). The clinical significance of IgG4 in RA with regard to disease act...

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Autores principales: Tan, Li Fen, Sakthiswary, Rajalingham, Veshaaliini, Uma Rajeswaran, Shaharir, Syahrul Sazliyana, Wahab, Asrul Abdul, Aziz, Suraya, Sutan, Rosnah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380629/
https://www.ncbi.nlm.nih.gov/pubmed/37510831
http://dx.doi.org/10.3390/jcm12144716
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author Tan, Li Fen
Sakthiswary, Rajalingham
Veshaaliini, Uma Rajeswaran
Shaharir, Syahrul Sazliyana
Wahab, Asrul Abdul
Aziz, Suraya
Sutan, Rosnah
author_facet Tan, Li Fen
Sakthiswary, Rajalingham
Veshaaliini, Uma Rajeswaran
Shaharir, Syahrul Sazliyana
Wahab, Asrul Abdul
Aziz, Suraya
Sutan, Rosnah
author_sort Tan, Li Fen
collection PubMed
description Immunoglobulin (Ig) G4 accounts for 4–6% of the total IgG in a healthy human. Several evidence-based studies have suggested that the level of IgG4 is significantly elevated in autoimmune diseases, including rheumatoid arthritis (RA). The clinical significance of IgG4 in RA with regard to disease activity, severity, and treatment response remains elusive. We consecutively recruited 174 patients with RA from our rheumatology clinic. All subjects were assessed for their disease activity based on DAS28, radiographic joint damage based on the Modified Sharp Score (MSS), the functional capacity based on the Health Assessment Questionnaire –Disability Index (HAQ-DI), and treatment responsiveness using the European League Against Rheumatism (EULAR) response criteria. The serum IgG4 of the recruited subjects was measured via the ELISA test. The mean serum IgG4 level was 60.23 ± 30.08 mg/dL. We found that serum IgG4 had significant positive correlations with disease activity (r = 0.406; p < 0.001), ESR (r = 0.155; p = 0.041), CRP (r = 0.269; p < 0.001), joint damage (r = 0.195; p = 0.012) and functional disability (r = 0.909; p < 0.001). Subjects with elevated IgG4 (IgG4 > 86 mg/dL) had significantly higher ESR, CRP, HAQ-DI, and DAS 28 and a poorer treatment response compared to the group with non-elevated IgG4. After multivariate analysis, only HAQ-DI (OR = 4.229, 95% CI 1.302, 15.751, p = 0.018) and DAS28 (OR = 3.743, 95% CI 1.062, 13.193, p = 0.040) remained significantly associated with elevated serum IgG4. The preliminary findings of this study could suggest serum IgG4 to be a potential biomarker of disease activity and functional disability in RA.
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spelling pubmed-103806292023-07-29 Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis Tan, Li Fen Sakthiswary, Rajalingham Veshaaliini, Uma Rajeswaran Shaharir, Syahrul Sazliyana Wahab, Asrul Abdul Aziz, Suraya Sutan, Rosnah J Clin Med Article Immunoglobulin (Ig) G4 accounts for 4–6% of the total IgG in a healthy human. Several evidence-based studies have suggested that the level of IgG4 is significantly elevated in autoimmune diseases, including rheumatoid arthritis (RA). The clinical significance of IgG4 in RA with regard to disease activity, severity, and treatment response remains elusive. We consecutively recruited 174 patients with RA from our rheumatology clinic. All subjects were assessed for their disease activity based on DAS28, radiographic joint damage based on the Modified Sharp Score (MSS), the functional capacity based on the Health Assessment Questionnaire –Disability Index (HAQ-DI), and treatment responsiveness using the European League Against Rheumatism (EULAR) response criteria. The serum IgG4 of the recruited subjects was measured via the ELISA test. The mean serum IgG4 level was 60.23 ± 30.08 mg/dL. We found that serum IgG4 had significant positive correlations with disease activity (r = 0.406; p < 0.001), ESR (r = 0.155; p = 0.041), CRP (r = 0.269; p < 0.001), joint damage (r = 0.195; p = 0.012) and functional disability (r = 0.909; p < 0.001). Subjects with elevated IgG4 (IgG4 > 86 mg/dL) had significantly higher ESR, CRP, HAQ-DI, and DAS 28 and a poorer treatment response compared to the group with non-elevated IgG4. After multivariate analysis, only HAQ-DI (OR = 4.229, 95% CI 1.302, 15.751, p = 0.018) and DAS28 (OR = 3.743, 95% CI 1.062, 13.193, p = 0.040) remained significantly associated with elevated serum IgG4. The preliminary findings of this study could suggest serum IgG4 to be a potential biomarker of disease activity and functional disability in RA. MDPI 2023-07-17 /pmc/articles/PMC10380629/ /pubmed/37510831 http://dx.doi.org/10.3390/jcm12144716 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tan, Li Fen
Sakthiswary, Rajalingham
Veshaaliini, Uma Rajeswaran
Shaharir, Syahrul Sazliyana
Wahab, Asrul Abdul
Aziz, Suraya
Sutan, Rosnah
Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title_full Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title_fullStr Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title_full_unstemmed Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title_short Decoding the Clinical Significance of Immunoglobulin G4 in Rheumatoid Arthritis
title_sort decoding the clinical significance of immunoglobulin g4 in rheumatoid arthritis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380629/
https://www.ncbi.nlm.nih.gov/pubmed/37510831
http://dx.doi.org/10.3390/jcm12144716
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