Expression Level And Clinical Significance Of Granulocyte-macrophage Colony Stimulating Factor In Serum Of Patients With Initial Treatment Of Rheumatoid Arthritis

Objective: In this study,differences in GM-CSF levels in RA patients in different DAS28 groups were assessed by measuring and comparing serum levels of granulocyte-macrophage colony-stimulating factor(GM-CSF)between patients with rheumatoid arthritis(RA)and healthy subjects.Correlations between GM-CSF levels and C-reactive protein(CRP),erythrocyte deposition rate(ESR),rheumatoid factor(RF),DAS28 score,and anti-cyclic citrullinated peptide antibody(CCP antibody)were evaluated in RA patients.This study aims to explore the expression level of GM-CSF in serum of patients with RA and its correlation with disease activity,so as to clarify its clinical significance.Methods: 44 patients diagnosed with rheumatoid arthritis admitted to Shengjing Hospital affiliated to China Medical University from January 2022 to November 2022 and 22 healthy patients admitted to Shengjing Hospital during the same period were identified by enzymedy-linked immunoassay(ELISA).Serum GM-CSF level,CRP level,ESR level,RF level and anti-CCP antibody level of RA patients were mainly determined.We calculated DAS28 score and determined serum GM-CSF level of healthy patients.Meanwhile,patients with RA were divided into disase remission group,low disease activity group,medium disease activity group and high disease activity group,through DAS-28 score.We statistically and retrospectively analyze the relationship between GM-CSF level in RA patients and healthy subjects,the relationship between GM-CSF level in different groups of RA patients,and the correlation between GM-CSF level in RA patients and CRP level,ESR level,RF level,DAS28 level and anti-CCP antibody level.Results: The level of GM-CSF in RA patients was significantly higher than that in healthy people,and the difference was statistically significant(P<0.01).The level of GM-CSF in RA patients was positively correlated with disease activity(correlation coefficient: 0.982,P < 0.01).The level of GM-CSF in patients with high disease activity group was significantly higher than that in disease remission group,low disease activity group and moderate disease activity group;the level of GM-CSF in patients with moderate disease activity group was significantly higher than that in patients with low disease activity group and disease remission group;the level of GM-CSF in patients with low disease activity group was significantly higher than that in disease remission group.The difference was statistically significant(P < 0.01).The level of GM-CSF measured in RA patients is positively correlated with CRP level(correlation coefficient 0.624,P <0.01),ESR level(correlation coefficient 0.675,P < 0.01),RF level(correlation coefficient 0.497,P < 0.05)and DAS28 score(correlation coefficient 0.982,P < 0.01).However,there is no prominent correlation with anti-CCP antibody level(correlation coefficient was 0.266,P > 0.05).Conclusion: Compared with healthy controls,serum GM-CSF level in RA patients was increased,and was in a positive correlation with disease activity.The detection of serum GM-CSF level has the potential to be used in clinical work to detect disease activity in RA patients,and the detection of serum GM-CSF level in RA patients in clinical work may have important clinical value for the condition evaluation of RA.