Version 1
: Received: 26 May 2023 / Approved: 29 May 2023 / Online: 29 May 2023 (08:56:15 CEST)
How to cite:
Balakrishnan, K.; Rajalingham, S.; Deborah, C.C.H.; Abdul Wahab, A.; Yaacob, Y.; Sutan, R. Elucidating the Effects of Methotrexate Therapy on Serum Cytokeratin-18 Levels in Rheumatology. Preprints2023, 2023051962. https://doi.org/10.20944/preprints202305.1962.v1
Balakrishnan, K.; Rajalingham, S.; Deborah, C.C.H.; Abdul Wahab, A.; Yaacob, Y.; Sutan, R. Elucidating the Effects of Methotrexate Therapy on Serum Cytokeratin-18 Levels in Rheumatology. Preprints 2023, 2023051962. https://doi.org/10.20944/preprints202305.1962.v1
Balakrishnan, K.; Rajalingham, S.; Deborah, C.C.H.; Abdul Wahab, A.; Yaacob, Y.; Sutan, R. Elucidating the Effects of Methotrexate Therapy on Serum Cytokeratin-18 Levels in Rheumatology. Preprints2023, 2023051962. https://doi.org/10.20944/preprints202305.1962.v1
APA Style
Balakrishnan, K., Rajalingham, S., Deborah, C.C.H., Abdul Wahab, A., Yaacob, Y., & Sutan, R. (2023). Elucidating the Effects of Methotrexate Therapy on Serum Cytokeratin-18 Levels in Rheumatology. Preprints. https://doi.org/10.20944/preprints202305.1962.v1
Chicago/Turabian Style
Balakrishnan, K., Yazmin Yaacob and Rosnah Sutan. 2023 "Elucidating the Effects of Methotrexate Therapy on Serum Cytokeratin-18 Levels in Rheumatology" Preprints. https://doi.org/10.20944/preprints202305.1962.v1
Abstract
Background: CK-18 is a serological marker of apoptosis that has been widely associated with fibrosis and steatosis in NASH. Many studies have showed association CK-18 levels with NAFLD. To date, there is a profound lack of rheumatology studies on the effect of MTX therapy with regard to CK-18 levels. The relationship between CK-18 levels and cumulative MTX dose, MTX treatment duration, weekly MTX dose is not available in the literature.
Objectives: The main purpose of this study was to determine the relationship between serum cytokeratin-18 (CK-18) and cumulative methotrexate dose in rheumatology patients on methotrexate (MTX) therapy. Besides, we studied the correlations between CK-18 and clinical parameters including age, disease duration , duration of MTX therapy, cumulative steroid dose and biochemical parameters such as alanine transaminase (ALT) and aspartate aminotransferase AST).
Methods : We recruited 79 rheumatology patients on methotrexate (MTX) therapy as MTX group and 38 patients not on MTX therapy as non-MTX group . All subjects were tested for their serum CK-18 levels using an enzyme-linked immunosorbent assay (ELISA) test. We identified 20 patients with the highest CK-18 levels and 20 patients with the lowest CK-18 levels and had ultrasound liver performed on them.
Results : The median serum CK-18 levels were marginally higher among the patients on MTX (1.20 ng/mL [0.19-37.15]) compared to the non-MTX group (1.17 ng/mL [0.37-34.32]). There was a significantly positive relationship between serum CK-18 levels and cumulative MTX dose (r = 0.329, p = 0.003) and total duration of MTX therapy (r = 0.284, p = 0.011). Apart from the above-mentioned variables, the CK-18 levels in MTX group significantly correlated with age (r = 0.265, p = 0.018), ALT (r = 0.440, p = <0.001) and AST (r = 0.478, p= 0.004). Ultrasound liver findings showed median CK-18 levels was higher among patients with abnormal liver findings although statistical significance was not reached.
Conclusion : Among patients on MTX therapy, serum CK-18 levels correlated positively with cumulative MTX dose , total duration of MTX treatment , ALT and AST levels. These findings are preliminary and requires validation by future studies in the field of rheumatology.
Keywords
methotrexate (MTX); rheumatoid arthritis (RA); cytokeratin -18 ( CK -18)
Subject
Medicine and Pharmacology, Internal Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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