Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
| Autor: | Yao-Yao Zou, Jian-Zi Lin, Jun Jing, Y. Y. Zou, C. Chen, Ying-Qian Mo, Jian-Da Ma, Dong-Hui Zheng, Qian Zhang, Y. H. Xu, Tao Wu, Xue-Pei Zhang, Pierre Miossec, Le-Feng Chen, Zehong Yang, Lie Dai, Li Ling |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male rheumatoid arthritis CD31 medicine.medical_specialty Time Factors Myeloid Stromal cell Knee Joint myeloid-stromal pathotype Immunology CD38 Gastroenterology Arthritis Rheumatoid Antigens CD Predictive Value of Tests Internal medicine medicine Humans Immunology and Allergy Prospective Studies Prospective cohort study Original Research stromal cells CD20 synovial tissue biology business.industry CD68 Biopsy Needle Remission Induction Synovial Membrane Fibroblasts Middle Aged RC581-607 medicine.disease Immunohistochemistry Treatment Outcome medicine.anatomical_structure radiographic progression Antirheumatic Agents Rheumatoid arthritis Disease Progression biology.protein Female Immunologic diseases. Allergy business Biomarkers |
| Zdroj: | Frontiers in Immunology, Vol 12 (2021) Frontiers in Immunology |
| ISSN: | 1664-3224 |
| DOI: | 10.3389/fimmu.2021.778480 |
| Popis: | ObjectivesThis study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA).MethodsActive RA patients with a knee needle synovial biopsy at baseline and finished 1-year follow-up were recruited from a real-world prospective cohort. Positive staining for CD20, CD38, CD3, CD68, CD31, and CD90 were scored semiquantitatively (0-4). The primary outcome was radiographic progression defined as a minimum increase of 0.5 units of the modified total Sharp score from baseline to 1 year.ResultsAmong 150 recruited RA patients, 123 (82%) had qualified synovial tissue. Higher scores of CD20+ B cells, sublining CD68+ macrophages, CD31+ endothelial cells, and CD90+ fibroblasts were associated with less decrease in disease activity and greater increase in radiographic progression. A new fibroblast-based classification of synovial pathotypes giving more priority to myeloid and stromal cells classified samples as myeloid-stromal (57.7%, 71/123), lymphoid (31.7%, 39/123), and paucicellular pathotypes (10.6%, 13/123). RA patients with myeloid-stromal pathotype showed the highest rate of radiographic progression (43.7% vs. 23.1% vs. 7.7%, p = 0.011), together with the lowest rate of Boolean remission at 3, 6, and 12 months. Baseline synovial myeloid-stromal pathotype independently predicted radiographic progression at 1 year (adjusted OR: 3.199, 95% confidence interval (95% CI): 1.278, 8.010). Similar results were obtained in a subgroup analysis of treatment-naive RA.ConclusionsThis novel fibroblast-based myeloid-stromal pathotype could predict radiographic progression at 1 year in active RA patients which may contribute to the shift of therapeutic decision in RA. |
| Databáze: | OpenAIRE |
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