Increased baseline RUNX 2 RUNX RUNX 2 , caspase 3 caspase 3 and p21 p21 gene expressions in the peripheral blood of disease‐modifying anti‐rheumatic drug‐na?ve rheumatoid arthritis patients are associated with improved clinical response to methotrexate therapy

摘要

Abstract Objective To investigate the potential of the baseline gene expression in the whole blood of disease‐modifying anti‐rheumatic drug‐na?ve rheumatoid arthritis ( RA ) patients for predicting the response to methotrexate ( MTX ) treatment. Methods Twenty‐six control subjects and 40 RA patients were examined. Clinical, immunological and radiographic parameters were assessed before and after 24 months of follow‐up. The gene expressions in the whole blood were measured using real‐time reverse transcription polymerase chain reaction. The protein concentrations in peripheral blood mononuclear cells were quantified using enzyme‐linked immunosorbent assay. Receiver operating characteristic curve analyses were used to suggest thresholds that were associated with the prediction of the response. Results Decreases in the disease activity at the end of the study were accompanied by significant increases in joint space narrowing score ( JSN ). Positive correlations between the expressions of the Unc‐51‐like kinase 1 ( ULK 1 ) and matrix metalloproteinase 9 ( MMP ‐9 ) genes with the level of C‐reactive protein and MMP ‐ 9 expression with Disease Activity Score of 28 joints ( DAS 28) and swollen joint count were noted at baseline. The baseline tumor necrosis factor (TNF)α gene expression was positively correlated with JSN at the end of the follow‐up, whereas p21 , caspase 3 , and runt‐related transcription factor ( RUNX )2 were correlated with the Δ DAS 28 values. Conclusions Our results suggest that the expressions of MMP ‐9 and ULK1 might be associated with disease activity. Increased baseline gene expressions of RUNX 2 , p21 and caspase 3 in the peripheral blood might predict better responses to MTX therapy.