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Life Sciences

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Published yearly: 

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ISSN: 2320-964X (Online) 

ISSN: 2320-7817  (Print)

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Dr. Santosh Pawar 


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ORIGINAL ARTICLE

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Int. Journal of Life Sciences, 2017; 5(2): 141- 150    |    Available online, June 27, 2017

Deciphering the association of celiac disease and other comorbidities in patients with rheumatoid arthritis using systems and clinical medicine approaches

Sami Bahlas MD1#, Ibtisam M Jali1, Laila Abdullah Damiati M. Sc2#, Nadia Dandachi MBBS1,

Hesham Sait MBBS1 and Peter Natesan Pushparaj PhD3

 

 

1Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia   |    2University of Jeddah, Jeddah, Kingdom of Saudi Arabia   3Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia

*Corresponding Author(s)

Dr. Peter Natesan Pushparaj PhD, Center of Excellence in Genomic Medicine Research (P.O.Box: 80216), Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah-21589 , Kingdom of Saudi Arabia

Email: peter.n.pushparaj@gmail.com or pnatesan@kau.edu.sa  | Mobile: +966557869423

Prof. Sami Bahlas MD, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah , Kingdom of Saudi Arabia | Email: drbahlas@gmail.com    | Mobile:+966505625857

#Authors contributed equally in this work


Received: 31.03.2017    |     Accepted: 23.06.2017    |      Published :27.06.2017

In this study, we decipher the association of celiac disease (CD) and other comorbidities in patients with rheumatoid arthritis (RA) using key clinical risk factors and systems medicine approaches for the differential diagnosis and personalized treatment.

In the systems medicine approach, we have used the Ingenuity Pathway Analysis knowledgebase (IPA, Qiagen, USA) to decipher the upstream regulators of the disease, canonical pathways, molecular networks and disease specific pathways commonly shared in RA and CD. Besides, eighty-two RA patients who have satisfied “American College of Rheumatology (ACR)” classification criteria for RA and 20 healthy volunteers were participated. RA patients with CD were identified based on serum levels of immunoglobulin A (IgA) autoantibodies to tissue transglutaminase (tTG-IgA). Besides, clinical parameters such as fasting blood sugar (FBS) and glycosylated hemoglobin A1C (HbA1C) were measured to assess the diabetic state. Clinical parameters such as erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), mean cell volume (MCV), mutated citrullinated vimentin antibodies (anti-MCV), white blood count (WBC), albumin, calcium (Ca2+) and vitamin D3 (VitD3) were analyzed in healthy volunteers, RA, and RA with CD cohorts respectively.

Systems medicine analyses showed that both RA and CD strongly associated with diabetes mellitus. Furthermore, clinical analyses indicate that FBS, HbA1C, Anti-MCV, RF, CRP and tTG-IgA concentrations were significantly increased in both RA and RA with CD cohorts than healthy controls. tTG-IgA levels were significantly elevated in RA with CD cohorts compared with RA. On the other hand, anti-MCV levels were significantly increased in RA compared to RA with CD group. Besides, both RA and RA with CD cohorts have significantly reduced levels of VitD3 and Albumin in the serum compared with healthy controls.

In conclusion, the RA and RA with CD cohorts have poor glycemic rheostat compared to healthy controls. Higher serum tTG-IgA levels in these cohorts indicate the susceptibility of RA patients to develop CD. The reduction in serum VitD3 levels in both RA and RA with CD cohorts further worsens disease prognosis. The systems medicine and clinical analyses, therefore, showed the potential association of diabetes mellitus (DM) and CD in RA patients.  

                                                                             

Key words: Rheumatoid Arthritis, Diabetes Mellitus, Celiac Disease, Immunoglobulin A, Tissue Transglutaminase, Fasting Blood Sugar, Vitamin D3, Personalized Treatment.

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Editor: Dr. Arvind Chavhan

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Cite this article as:

Sami Bahlas, Laila Abdullah Damiati, Nadia Dandachi, Hesham Sait, Peter Natesan Pushparaj (2017) Deciphering the association of celiac disease and other comorbidities in patients with rheumatoid arthritis using systems and clinical medicine approaches, International J. of Life Sciences, 5  (2): 141-150.

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Acknowledgement:

Prof.Sami Bahlas is currently supported by DSR small grants. Dr.Peter Natesan Pushparaj is funded by the King Abdulaziz City of Science and Technology (KACST) Strategic Grants (KACST 12-BIO2719-03 & 12-BIO2267-03). We thank all the patients and healthy volunteers for their participation in this study.

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Conflicts of interest: The authors stated that no conflicts of interest.

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Copyright: © 2017 | Author(s), This is an open access article under the terms of the Creative Commons Attribution-Non-Commercial - No Derivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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