RhA - Rheumatoid Arthritis
Conditions
Keywords
Adversity, Rheumatic diseases
Brief summary
Epidemiological evidence shows that adverse experiences, particularly, but not exclusively in childhood, are predictors of poor long-term health outcomes and certain social domains. In the field of rheumatic diseases, traumatic events, not only in childhood, have been associated with hospitalization, chronic pain, inflammation, worse outcomes, severity of the disease, and mortality. Some mechanisms proposed to explain the association between the experience of adversity and the development of chronic diseases include an impact on the physiology of immune system cells, gene expression due to DNA modification, and cellular senescence. With this background, the investigators wonder if, for patients with rheumatoid arthritis, the presence of adversity understood as a history of violence in childhood and abuse due to suffering from rheumatoid arthritis is associated with markers of cellular senescence and with the severity of illness.
Detailed description
To answer this question, the investigators proposed conducting a study on outpatients diagnosed with rheumatoid arthritis treated at the INCMNSZ. Patients who agree to participate will be asked to answer some questionnaires to report their perception of child abuse and abuse derived from suffering from rheumatoid arthritis, disease activity, disability, quality of life, anxiety, stress, depression, and resilience. Additionally, a peripheral blood sample will be taken to evaluate cellular senescence through CD27, CD28, and CD57 expression, the relative expression of the p16INK4a gene in CD3+ lymphocytes, HLA-DR, CD25, and CD69, and telomere length. Finally, the expression of the severity of the disease will be determined.
Interventions
In 2012, Giraldo-Rodríguez developed and validated the Geriatric Mistreatment Scale (GAS); translation, cultural adaptation, and validation were performed prior to its application.
RAPID- 3 measures: function, pain, and patient global status estimate. Each of the three individual measures is scored 0 to 10, for a total of 30
The HAQ is based on five patient-centered dimensions: disability, pain, medication effects, costs of care, and mortality.
OTHERWHOQOL-BREF
WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items
DASS-21 is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains seven items, divided into subscales with similar content.
The Brief Resilient Coping Scale is a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner.
GENETICExpression of CDKN2A /p16INK4a
CDKN2A/p16INK4a expression will be measured using the Taqman qPCR assay (TaqMan Universal Master Mix II, with UNG, Applied Biosystems, Foster City, USA) according to the manufacturer's specifications.
OTHERImmunophenotype of leukocyte subpopulations
CD4+ and CD8+ subpopulations will be analyzed. Blood samples will be analyzed by 8-color flow cytometry (Becton Dickinson Canto II cytometer) using fluorescently labeled antibodies from Biolegend Inc. (San Diego, USA).
GENETICTelomere length
The rLTL will be estimated by quantitative monochromatic multiplex PCR (MM-qPCR). Integrated DNA Technologies, Inc. (IDT, Coralville, IA, USA) will synthesize the primers used for telomere measurements.
OTHERCellular senescence
Expression of co-stimulatory molecules and surface receptors CD27- and CD28-
Sponsors
National Institute of Medical Sciences and Nutrition, Salvador Zubiran
Study design
Observational model
CASE_CROSSOVER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patients with a rheumatoid arthritis diagnosis, according to their primary rheumatologist who agrees to participate
Exclusion criteria
* Patients with a not confirmed rheumatoid arthritis diagnosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adversity and senescence in patients with rheumatoid arthritis | At inclusion (baseline moment) (cross-sectional study)] | To evaluate whether the presence of adversity (history of abuse in childhood and/or abuse associated with RD) is associated with markers of senescence in patients with rheumatoid arthritis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Eexpression of the p16INK4a gene in CD3+ | At inclusion (baseline moment) (cross-sectional study)] | Compare the relative expression of the p16INK4a gene in CD3+ lymphocytes between rheumatoid arthritis patients with and without adversity. |
| Telomere length | At inclusion (baseline moment) (cross-sectional study)] | Compare telomere length between RA patients with and without adversity. |
Contacts
Primary ContactVirginia MD Pascual-Ramos, MD
Backup ContactIrazu MD Contreras-Yáñez, MD
Outcome results
None listed