History

Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease, which mainly involves the joints. RA is prevalent worldwide with increasing prevalence in elderly people. The mechanism of RA pathogenesis is still undefined, and it is interplaying between genetic susceptibility and environmental factors. Although risk factors for RA are not fully established, various studies have focused on the role of trace elements in association with RA. Patients take different types of medicines according to the activity of their disease, so the study focused on the effect of this variety of medicines according to the severity of the disease at the level of these elements. Objective This work aimed to measure serum level of Coll2-1, andsome trace elements in RA patients, study its association with disease activity and/or severity, types of treatment and to determine its ability as a biomarker of the disease status . Method: This study was conducted at Baghdad Teaching Hospital and at Ghazi Al-Hariri Hospital in the Medical City of Baghdad, Iraq, from November 2022 to March 2023. It included 130 Iraqi patients with rheumatoid arthritis. (60) patients treated with disease-modifying anti rheumatic drugs (group A) and 70 patients treated with biological treatments (group B). (98 female and 32 male). Their age range from (35– 65) years. The diagnosis of each case was identified by a clinical examination by a specialist rheumatologist and verified by a radiological and laboratory investigation. Results: The mean levels of Zinc,Copper, Selenium, Collagen type I, and Collagen type II were significantly higher in the group A compared to that in the group B(P ≤0.05) .No significant difference (P ≤ 0.05) was found in the mean concentration of Iron between the two groupsAs in the case of age, sex and body mass index .this results can be considered an important parameter for early detection of rheumatoid arthritis and can also be used to determine the activity of rheumatoid arthritis.study patients according to activity of their disease revealed that patients with severe disease activity had a significantly lower levels of Iron and collagen type-II (p- value =0.001)compared to those with mild to moderate disease activity. Also according to the results Shaw by using Receiver operating characteristic (ROC) curve analysis that a constructed for Iron and collagen type-II levels as predictors for severity of rheumatoid arthritis.Conclusion: This study highlighted the importance of Coll. 2 and certain trace elements as biomarkers for following RA disease activity. Accordingly, it was concluded that the levels of iron and collagen type II could be reliable as good indicators of the severity of rheumatoid arthritis.