Background: T cell chemokines and its receptors play important roles in the development and progression of rheumatoid arthritis (RA). Their involvement has been reported in inflammatory autoimmune diseases. However, their role in RA in the Ghanaian population has not been explored. We evaluated the intracytoplasmic CD4+ T cell chemokine receptors in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity. Methods. This case control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from the orthopaedic units of Komfo Anokye Teaching Hospital (KATH), Kumasi and Korle-Bu Teaching Hospital (KBTH), Accra, Ghana. A well-structured questionnaire was used to obtain sociodemographic data. Blood samples were also collected and processed for flow cytometric analysis. Statistical analyses were done using SPSS version 26.0 and R programming language. Results: This study found a significant difference in age group (p < 0.0001), marital status (p ¬= 0.0210), occupation (p = 0.0140), educational level (p = 0.0210) and religion (p = 0.0100) between RA patients and healthy controls. Moreover, haemoglobin level (p = 0.0010), waist circumference (p < 0.0001) and hip circumference (p = 0.0040) were significantly different between RA patients and healthy controls. RA patients had significantly lower levels of CD4+CD183+ compared to the control group (p < 0.001), and was positively correlated with DAS score (r = 0.0397, p = 0.789). In Receiver Operator Characteristics analysis, CD4+CD183+ could significantly detect rheumatoid arthritis with a very high area under the curve (AUC = 0.687, p = 0.018). At a cut-off of 0.082, CD4+CD183+ was the best chemokine receptor for detecting RA with a sensitivity of 90.0%, specificity of 25.9%, a positive predictive value of 69.2%, and a negative predictive value of 58.3%. Conclusion: CD4+CD183+ could serve as useful diagnostics and disease-monitoring marker for rheumatoid arthritis in the Ghanaian population.

Objective The study used both subjective, Suboptimal Health Status (SHS) concept along with objective, biomarkers of oxidative stress (OS): 8-OHdG, 8-epi-PGF2α and total antioxidant capacity (TAC); and angiogenic growth mediators (AGMs): VEGF-A, sFlt-1, PlGF and soluble endoglin (sEng) for predicting early-onset (EO) and late-onset (LO) preeclampsia (PE) Design A hospital-based longitudinal nested case-control study Setting Obstetrics and Gynaecology Department at Komfo Anokye Teaching Hospital, Ghana Population/Sample Singleton normotensive pregnancies (NTN-P) at baseline W1 (10-20th week gestation) (n= 593) of which 498 (197 developed PE) completed the study. Methods: The overall health status of the NTN-P participants was assessed at W1 and categorised as SHS and optimal health status (OHS) using a validated SHS questionnaire-25. Participants were followed at W2 (21-31st week, mid-pregnancy) and 32-42nd week. Samples were collected and analysed for biomarkers of OS and AGMs at the three-time points. Main Outcome Measures Receiver operative characteristics curve analysis was performed for the single and combined W1 and W2 biomarkers of OS and AGMs for predicting PE and its subtypes (EO-PE and LO-PE) Results Compared to single biomarkers of OS and AGMs, their combined ratios particularly, the W2 8-OHdG/PIGF ratio was a potent biomarker for PE [AUC=0.93]. Additionally, 8-OHdG/PIGF ratio best identified SHS-pregnant women who later developed EO-PE [AUC=0.97] and LO-PE [AUC=0.93]. Moreover, 8-OHdG/PIGF ratio best identified OHS-pregnant women who later developed EO-PE [AUC=0.94] and LO-PE (AUC=0.94). Conclusion Combination of biomarkers of OS and AGMs, particularly, mid-pregnancy 8-OHdG/PlGF ratio is a potent biomarker for PE and its subtypes.