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Testing for autoantibodies is a flagship feature of Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disorder affecting both the male and female population. Synovial inflammation followed by cartilage, bone, and joint destruction in the later stages of RA puts life in peril, especially for those with other comorbidities. In this study, we focused on to measure serum Hyaluronic acid (HA) along with seropositive and seronegative RF, AntiCCP autoantibodies to establish any association with these biomarkers. It was a cross-sectional study involving 152 RA patients based on the 1987 ACR criteria for the diagnosis of RA and 68 age‑ and sex-matched healthy controls. After clinical examination, the traditional markers were assessed to measure the disease activity, such as CRP, ESR, Anti -CCP, and RF in RA patients. The serum HA levels were measured using the ELISA method. All the values were expressed as median (25th–75th percentile). Based on seropositive and seronegative RF and AntiCCP autoantibodies, the patient group was divided into four groups- both seropositive, both seronegative, and the other two mixed groups. The traditional inflammatory markers were significantly increased in RA patients than in controls with (p < 0.001). In our study, there was a significant increase in serum HA levels in RA patients compared to healthy controls (p < 0.03). The serum HA levels were significantly correlated with Anti-CCP, DAS‑28, CRP, and ESR in RA patients. At the same time, serum HA level is increased in the group with seropositive for both antibodies showing statistical significance. Conclusion- serum Hyaluronic acid is involved in synovial inflammation, manifesting a common triggering mechanism more with AntiCCP antibodies than RF, promising for better clinical utility in the early stages of rheumatoid arthritis.
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