- Rheumatological Assessment:
Rheumatoid Arthritis patients were selected from the Rheumatology and Rehabilitation Department, Faculty of Medicine, Mansoura University. Those patients were diagnosed as being rheumatoid following the American College of Rheumatology (ACR) criteria (54). Disease activity for each patient assessed using DAS28 ESR score involving evaluation of 28 joints (0-28) either tender or swollen and the patient’s global assessment of a well-being on 10 cm visual analogue scale .ESR measured by laboratory investigation of the patient’s serum. This DAS 28 ESR score measured at the baseline and again after 2 months of periodontal therapy.
V- Blood Samples Collection
• Whole blood specimens was collected using acceptable medical techniques to avoid hemolysis.
• Blood was allowed to clot and the serum or plasma was separated by centrifugation.
• Test serum should be clear and non-hemolyzed. Contamination by hemolysis or lipemia was avoided, but did not interfere with this assay.
• Specimens may be refrigerated at 2-8°C for up to five days
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It was considered that high RF titers are accompanied by more severe disease and the occurance of extra articular features and rheumatoid nodules (144). This conclusion may depend on the disease duration. Serum IgM RF may start before the onset of RA by many years. A high titer of RF in non-RA individuals indicate increased risk of developing RA. In the first 2 years of RA (early RA), serum levels of IgM, IgG and IgA RF do not correlate with disease activity. Serum IgG and IgA RF in these years are prognostic of erosive joint disease. In RA patients, high titer serum IgM associated with the presence of articular disease and nodules but not with systemic disease activity (145). The presence of IgM RF complexes with bound complement (C1q) C is also indicating extra-articular RA