الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Rheumatoid arthritis (RA) is the most common autoimmune inflammatory joint disease worldwide.(1) It affects 1% of the world population and triggers joint inflammations that may worsen patient’s quality of life.(2) Despite the noticeable
advances in the treatment of RA, mortality among patients with RA continues higher than that of the general population, with no significant changes in recent years.(3)
MTX is the anchor disease-modifying antirheumatic drug (DMARD) in RA treatment. It is used as monotherapy and/or in combination with other synthetic or biological DMARDs, and is known to have the best cost-effectiveness and efficacy/toxicity ratios. However, toxicity is still a concern. Studies about the cytotoxicity (chromosomal aberrations) and the genotoxicity (DNA damage) in RA and due to the use of DMARDs are scarce in the literature.
The aim of the present work was to assess the chromosomal aberrations (as a measure of cytotoxicity) and micronuclei (as a measure of genotoxicity) in patients with rheumatoid arthritis and its relation to the disease activity. The present work also aimed to assess the possible cytotoxicity and genotoxicity induced by some Disease Modifying Anti-Rheumatic Drugs (DMARDs) used for treatment of rheumatoid arthritis patients.
The study included 40 female subjects: a- 30 patients with rheumatoid arthritis were divided into two subgroups: 10 patients with RA receiving no medication except Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and 20 patients with RA receiving DMARDs (Methotrexate, and Salazopyrin) as a single drug or in combination and
b- 10 healthy female control subjects matching the same age. A written consent from each patient was taken.
All patients were subjected to the following:
I- History taking as regards:
a- Demographic data: Age, ethnic group (nationality), smoking, and duration of the disease,
b- Drug history: Type, dose, and duration of use of the DMARDs medication, and
the use of folic acid with its dose (0.5 mg/day), and
c- Pregnancy history: use of contraceptive pills and number of abortions.
II- Clinical data for the disease activity: This was done by applying the 4th version of
DAS28 (ESR or CRP).
III- Cytotoxicity assessment: It was performed by karyotyping (chromosomal analysis) using solid Giemsa stain and GTG- banding technique according to the International System for Human chromosome Nomenclature (ISCN).
IV- Genotoxicity study: by doing the cytokinesis-block micronucleus test (CBMN)
using cytochalasin- B.