![]() ![]() ![]() As gender plays an important role in aging, 18 and the incidence of RA is around 80% in females, with multiple manifestations, including disease activity and co-morbidities that are different from male patients, 19 we enrolled only females in this study. Ust 2019 to March 2021 with RA patients (n = 134) recruited from Rheumatology Department and healthy controls (HC, n = 38) from Health Management Center of Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, China. Thus, by correlating the A/G ratio with ARDs and inflammatory cytokines, we can explore the Yin–Yang nature of A/G, and also its potential linkage with the inflamm-aging process. 17 Based on this knowledge, we hypothesize that A/G might also be involved in the prognosis of RA. 15, 16 Interestingly, traditional Chinese medicine (TCM) theory put forward by Zhu Danxi (1281–1358) in ancient China described the pathogenesis of common internal diseases as Yin is insufficient, while Yang is in surplus. It is documented that most if not all ARDs and even other internal diseases share inflammatory pathways. For example, recent studies explored its correlation with the survival and mortality of various cancers, uremia, and heart failure, 10−12 as well as with ARDs like chronic obstructive pulmonary disease, cardiovascular diseases, and cognitive disorders. ![]() Albumin/globulin (A/G) ratio is a classic clinical index that can provide unspecific information about various diseases. 9 From the perspective of physiology and pathology, one can assign the pair of albumin and globulin levels to Yin and Yang, which indicate dual sides of the immune balance. 8 Conversely, high globulin level indicates inflammatory conditions related to viral and bacterial infections, as well as inflammatory or immune disorders. It is associated with poor quality of life and reduced longevity. Therefore, hypoalbuminemia results from and reflects the inflammatory state. Although fractional synthesis of albumin increases due to decreased plasma level, the half-life of albumin tends to shorten significantly, which further decreases albumin levels. Inflammation increases permeability of capillaries causing escape of serum albumin into interstitial space. Therefore, an accessible clinical index will help in identifying ARDs concomitant to AIDs that can lead to prevention of progress in inflamm-aging. In daily clinical work, the inner cause and effect of RA and ARDs reflecting the inflamm-aging process are usually neglected. 7 Nevertheless, a recognized clinical marker is currently lacking that could be applied in daily clinical practice to interpret the inflamm-aging process. 6 Pro-inflammatory cells and cytokines that participate in the inflamm-aging process have been broadly investigated. 5 Trf2 is a telomere associated protein having a crucial role in the maintenance of telomere. In autoimmune diseases, leptin resistance is observed, which has a role in the generation and maintenance of autoimmunity. Leptin regulates both innate and adaptive immunity mainly through pro-inflammatory effects. 2 Evidence from clinical observations suggested that patients with AID like RA, systemic lupus erythematosus, ankylosing spondylitis and Behcet’s disease, exhibit susceptibility to ARDs, especially cardiovascular disease (CVD), diabetes etc. ![]() 1 The concept of inflamm-aging has gained ground because chronic inflammation proved to be one of the mechanisms that could contribute to the pathogenesis of senility and age-related diseases (ARDs). Besides bone and cartilage of joints being most susceptible tissues, other organs could also be involved in the disease manifestations, including anaemia, osteoporosis, infection, and damage to skin or lungs. Rheumatoid arthritis (RA) is one of the most common, systemic, chronic autoimmune diseases (AID). ![]()
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