Cytotoxicity And Genotoxicity In Rheumatoid Arthritis: A Dual Effect Of Disease And Drugs.

Introduction/ Objectives: to assess cytotoxicity and genotoxicity in RA and the possible cyto and genotoxic effects of some DMARDs used in treatment. Methods: The study included 30 female RA patients divided according to treatment into three groups and 30 healthy controls. Cytotoxicity was assessed by chromosomal analysis (karyotyping). Genotoxicity by the micronucleus test using cytochalasin–B. Results: Compared to controls, RA patients had significantly higher CAs in the form of breaks, satellite association, endoreduplication, aneuploidy, double minute, and other aberrations. There was also a statistically significant increase in the markers of genotoxicity in RA patients compared to controls: micronuclei (MN), nucleoplasmic bridges (NPB) and necrotic and/or apoptotic cells. CAs were found in all RA groups, those receiving DMARDs as well as the DMARD naieve group. CAs, the number of binucleated (BN) cells with MN, NPB, and the necrotic and/or apoptotic cells was were significantly higher in MTX and in MTX-SSZ group when compared to RA on NSAIDs only. Conclusions: RA patients show significantly increased markers of cytotoxicity and genotoxicity, regardless the type of medications received, sugggesting them to represent underestimated disease features which could provide new insights into its pathogenesis.