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MTHFR Gene Polymorphisms in Iraqi Kurdish Rheumatoid Arthritis Patients: Relation to Methotrexate Response and Toxicity

     Methotrexate (MTX) is still one of the gold standard treatments for rheumatoid arthritis (RA). It shows diverse outcomes in blood level and clinical response, this was demonstrated by its relation to the genetic polymorphism in the pharmacogenetic study. This study aimed to investigate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in relation to MTX efficacy and toxicity in Iraqi Kurdish RA patients. Sixty-four RA patients were involved in this study with an average age of 47.78 ±14.08 and female to male ratio of (8.1). Diagnosis and disease activity were confirmed. Blood analyses, including those of laboratory markers of disease activity, were done. The 28 joint disease activity score (DAS28-CRP) was calculated.  MTHFR gene polymorphisms were analyzed by real-time polymerase chain reaction. The most frequent genotypes which were identified in RA patients were the CT genotype of the C677T single nucleotide polymorphism (SNP) (51.6%) and the AC genotype of the A1298C SNP (48.4%). Patients with non-response to treatment had high frequencies of genotypes CT and TT (58.0% and 12.0%) of the C677T SNP respectively, as compared to those in the responder group; 28.6% and 0.0%); T-allele was associated with drug non-responding OR=4.17, P value=.0.009, meanwhile; genotypes AC and CC of the A1298C SNP were seen in (54.0% and 16.0%) in non-responder group. Patients with active RA had increased frequencies of CT and TT genotypes of the C677T SNP (60.0% and16.0%) respectively as compared to those who were in remission (26.6% and 0.0%); T-allele was associated with high disease activity; OR = 5.11. No association was found between C677T SNP and A1298C SNP, and MTX level status (P> 0.05). However, the variant alleles (T and C) were associated with the MTX toxic level (OR: 2.05, 95% CI [0.97 – 4.32]) and (OR: 1.99, 95% CI [0.96 – 4.18]) respectively. This study suggests that genetic polymorphisms of MTHFR SNP (C677T and A1298C) are associated with MTX efficacy but not toxicity in RA patients. This may assist the physicians in personalizing RA treatment in Iraqi patients.

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Publication Date
Tue Feb 27 2024
Journal Name
Pharmacia
Association of the rs1801133 and rs1801131 polymorphisms in the MTHFR gene and the adverse drug reaction of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients

Background: Methotrexate is one of the mainstays for treating rheumatoid arthritis (RA) with a wide range of adverse drug reactions, however, it’s the relationship between adverse drug reactions and genetic polymorphism remains to be highlighted, and there is a lack of studies concerning Arabic Iraqi population regarding this aspect.

Objective: Evaluate the association between genetic mutations in the MTHFR gene in SNPs (rs1801133G>A and rs1801131T>G) on the adverse drug reaction for RA Iraqi patients.

Methods: An observational study, that involved 95 Iraqi RA patients with established RA. Patien

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Publication Date
Tue Jul 02 2024
Journal Name
Scientific Reports
Impact of MTHFR gene polymorphism on the outcome of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients
Abstract<p>Analyze the relationship between genetic variations in the MTHFR gene at SNPs (rs1801131 and rs1801133) and the therapy outcomes for Iraqi patients with rheumatoid arthritis (RA). The study was conducted on a cohort of 95 RA Iraqi patients. Based on their treatment response, the cohort was divided into two groups: the responder (47 patients) and the nonresponder (48 patients), identified after at least three months of methotrexate (MTX) treatment. A polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) technique was employed to analyze the MTHFR variations, specifically at rs1801133 and rs1801131. Overall, rs1801131 followed both codominant and dominate models, in which in </p> ... Show More
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Publication Date
Thu Nov 16 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Evaluating TLR4 Gene Expression to Monitor Disease Progression in Iraqi Patients with Rheumatoid Arthritis

Background: Toll-like receptors (TLRs) play a significant role in the activation of adaptive immunity and may have an essential role in the development of rheumatoid arthritis (RA). Objectives: To assess the gene expression of TLR4 in individuals with RA compared to healthy individuals. Methods: From July to December 2022. A total of 100 individuals were encompassed in the study, consisting of 50 individuals diagnosed with RA, of whom 42 were females and 8 were males, with an average age of 45.22 years. Additionally, there were 50 healthy control participants, 40 of whom were females and 10 were males, with an average age of 45.64 years. To assess the TLR4 transcript levels, blood samples were collected from each participant, and RN

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Publication Date
Sun Apr 05 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Predictors of Response to (Etanercept) in the Treatment of Iraqi Patients with Active Rheumatoid Arthritis

Background: Since the introduction of tumour necrosis factor-alpha (TNF-α) inhibitors including etanercept, their efficacy and safety in treatment of rheumatoid arthritis (RA) have been studied in many randomized controlled clinical trials. However, data regarding predictors of clinical response to anti-TNF therapy are still sparse.
Objective: To assess the predictors of response to etanercept in treatment of Iraqi patients with active RA.
Methods: An open label single group prospective study was conducted over 15 months on 190 Iraqi patients with RA. All the included patients were given etanercept at a dose of 50 mg by subcutaneous injection on
a weeklybases. Each patient was followed at regular intervals of bas

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Publication Date
Fri Feb 17 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn: 2789-3219 )
The Association of Genetic Polymorphisms in Tumor Necrosis Factor-Alpha and Interleukins with Disease Severity or Response to Biological Therapy in Iraqi Rheumatoid Arthritis Patients: A Narrative Review

Background: Tumor necrosis factor-alpha (TNF-α) and interleukins play important roles in the pathogenesis of rheumatoid arthritis (RA). Genetic research has been employed to find many of the missing connections between genetic risk variations and causal genetic components. Objective: The goal of this study is to look at the genetic variations of TNF-α and interleukins in Iraqi RA patients and see how they relate to disease severity or response to biological therapy. Method: Using specific keywords, the authors conducted a systematic and comprehensive search to identify relevant Iraqi studies examining the genetic variations of TNF-α and interleukins in Iraqi RA patients and how they relate to disease severity or response to biolo

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Publication Date
Sun Jun 03 2018
Journal Name
Baghdad Science Journal
Gene Expression and Polymorphism of Interleukin-4 in a Sample of Iraqi Rheumatoid Arthritis Patients

It was aimed to understand the interleukin-4 (IL-4) role in etio-pathogenesis of rheumatoid arthritis (RA). Two approaches were adopted. In the first one, a quantitative expression of IL4 gene was assessed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and such findings were correlated with some demographic, clinical and laboratory parameters, which included gender, duration of disease, disease activity score (DAS-28), rheumatoid factors (RFs), C-reactive protein (CRP) and anti-cyclic citrullinated peptide (ACCP) antibodies. In the second approach, a single nucleotide polymorphism (SNP) of IL4 gene (rs2243250) was inspected by DNA sequencing using specific primers. Fifty-one Iraqi RA patients (22 males and 29 fem

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Publication Date
Sun Oct 22 2023
Journal Name
Iraqi Journal Of Science
Detection of Toxoplasma Antibodies and TNF-α in Rheumatoid Arthritis Patients Treated with Methotrexate

This study was conducted to evaluate the prevalence rate of
toxoplasmosis among 294 rheumatoid arthritis (RA) patients treated with
methotrexate (MTX), 50 RA patients without treatment and 50 samples as
healthy control. Blood samples were collected and the presence of T.gondii
IgG and IgM antibodies was determined by using Enzyme linked
immunosorbent assay (ELISA). Tumor necrosis factor alpha (TNF-α) was
also estimated in serum of all subjects by using ELISA method too. The
seroprevalence of toxoplasmosis IgM and IgG in RA+MTX was
60(20.408%), and 98(33.33%), in RA patients 4(8%), and 18(36%) while,
it was 2(24%), 6(12%) in healthy group. Tumor necrosis factor alpha
(TNF-α) was also estimated in serum of a

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Publication Date
Sun Apr 03 2005
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serum Lipids in Patients with Active Rheumatoid Arthritis And It's Relation to Drug Therapy

Objective To detect the changes in serum Lipids among Iraqi patients with active Rheumatoid Arthritis (RA) and the effects of drug therapy.
Patients and methods Fifty Iraqi patients with untreated active Rheumatoid Arthritis and 50 matched healthy control were studied with concentration on estimation of fasting serum Lipid profile which is repeated after 3month treatment with different disease modifying anti Rheumatic drugs (DMARDs) regimens.
Results Fifty Iraqi patients were included in this prospective study 47 females (94%) and 3 males (6%). The mean age of patients was (45±3.20).
fifty healthy individuals were included in this study as a control group 45 females (90%) and 5 males (10%) the mean age of the control group was

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Publication Date
Wed Jun 27 2018
Journal Name
Iraqi Journal Of Science
Single Nucleotide Polymorphism of IL1B Gene (rs16944) in a Sample of Rheumatoid Arthritis Iraqi Patients

Cytokines play a prominent role in etiology and pathogenesis of rheumatoid arthritis (RA), and one of these cytokines is interleukin-1β (IL-1β). The association between IL1B gene single nucleotide polymorphism (SNP: rs16944) and rheumatoid arthritis (RA) in a sample of Iraqi patients was investigated. Fifty-one RA patients (21 males and 30 females) were enrolled and their age range was 20 - 63 years (44.9 ± 1.5 years). In addition to patients, 45 apparently healthy control subjects were also enrolled in the study. They matched patients for ethnicity (Iraqis), gender (14 males and 31 females) and age (41.3 ± 1.3 years). Analysis of Hardy-Weinberg equilibrium (HWE) in RA patients and controls revealed that the IL1B ge

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Publication Date
Fri May 24 2013
Journal Name
American Journal Of Pharmacological Sciences
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