Abstract
Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by synovial inflammation and joint destruction. Infliximab, a chimeric monoclonal antibody against tumor necrosis factor-alpha (TNF-α), has been widely used for the treatment of RA.
Objectives: This study aims to evaluate serum levels of triosephosphate isomerase (TPI), an enzyme involved in glycolysis, in RA patients undergoing infliximab therapy compared to healthy controls.
Patients and Methods: This prospective case-control study at AL-Yarmouk Teaching Hospital in Baghdad, Iraq, involved 65 RA patients undergoing infliximab therapy and 25 healthy controls, with ethical approval obtained from Mustansiriyah University. Data collection included demographic information and blood samples, where serum was isolated for TPI analysis using ELISA, while whole blood was retained for erythrocyte sedimentation rate (ESR) measurement. Disease activity was evaluated according to Clinical Disease Activity Index (CDAI) scores and ESR levels.
Results: Results from the study indicated that among 90 participants (84.4% female), 65 were diagnosed with RA and 25 were healthy controls. A statistically significant correlation was found between serum TPI levels and RA, with an odds ratio (OR) of 81.12; after adjusting for confounding variables, TPI remained an independent predictor of RA diagnosis (OR=12.73), suggesting that higher TPI levels are significantly associated with the disease. Furthermore, TPI demonstrated high diagnostic sensitivity and specificity at 98.5% and 100%, respectively, with a significance level of P<0.05, underscoring its potential utility as a biomarker for RA.
Conclusion: The results demonstrated a significant correlation between elevated TPI levels and RA, with TPI serving as an independent predictor of the disease. The findings, which include a high sensitivity of 98.5% and specificity of 100%, suggest that TPI could be a valuable biomarker for the early diagnosis and management of RA.