Evaluation Serum Levels of Aggrecan, Fibulin-1, Lubricin, and &beta;-Defensin 3 in Females with Rheumatoid Arthritis

Shihab, Istabraq Ahmed; Alaaraji, Shakir F. T.; Alkubaisi, Samah A. S.

doi:10.33091/amj.2026.169892.2617

	Evaluation Serum Levels of Aggrecan, Fibulin-1, Lubricin, and β-Defensin 3 in Females with Rheumatoid Arthritis
Al- Anbar Medical Journal
Volume 22, Issue 3, July 2026, Pages 178-184 PDF (473.88 K)
Document Type: Original articles
DOI: 10.33091/amj.2026.169892.2617
Authors
Istabraq Ahmed Shihab^* ¹; Shakir F. T. Alaaraji²; Samah A. S. Alkubaisi³
¹Department of Chemistry, College of Science, University of Anbar, Ramadi, Iraq.
²Department of Chemistry, College of Education for Pure Sciences, University of Anbar, Ramadi, Iraq.
³Department of Biology, College of Education, University of Fallujah, Fallujah, Iraq.
Abstract
Background: Rheumatoid Arthritis (RA) is a chronic, systemic autoimmune inflammatory disease primarily affecting the joints. Despite the availability of diagnostic tools, identifying novel biomarkers that reflect joint pathology remains crucial for the accurate evaluation of RA. Objective: To assess the serum levels of novel joint-related biomarkers (aggrecan, fibulin-1, lubricin, and human beta-defensin 3 [HBD-3]) in females with RA, and to determine their diagnostic performance compared to healthy controls (HC). Materials and methods: This case-control study included 60 female RA patients and 60 age-matched HC. Serum concentrations of aggrecan, fibulin-1, lubricin, HBD-3, and anti-citrullinated protein antibody (ACPA) were determined using ELISA kits. Erythrocyte sedimentation rate (ESR) was measured via the standard Westergren method. Results: Serum levels of aggrecan, fibulin-1, lubricin, and HBD-3 were significantly increased in RA patients compared to HC (P-value = 0.0001). For predicting disease status, the biomarkers yielded the following area under the receiver operating characteristic (AUROC) curve values: aggrecan (0.947, cut-off > 15.80 ng/mL), fibulin-1 (0.885, cut-off > 7.975 ng/mL), HBD-3 (0.885, cut-off > 325.2 pg/mL), and lubricin (0.719, cut-off > 169.4 pg/mL). Additionally, these biomarkers showed significant positive correlations with each other and with ACPA levels. Conclusion: Serum aggrecan, fibulin-1, lubricin, and HBD-3 are significantly elevated in RA patients, indicating strong disease association and high diagnostic potential. Future longitudinal studies are required to establish definitive clinical utility in monitoring disease activity.
Keywords
Aggrecan; Fibulin-1; HBD-3; Lubricin; Rheumatoid arthritis

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