Background: B cells arose as important players in the pathogenesis of Rheumatoid Arthritis (RA). Objectives: To define the phenotypic subsets of CD19+ cells in RA patients in the peripheral blood (PB) as well as in the synovial compartment and to correlate them with clinical and biological characteristics. Methods: Thirteen healthy subjects and 33 RA patients (18 females and 15 males, mean age 57.6±12.7years, mean disease duration 6.1± 6.4 years) were analyzed for the expression by flow-cytometry (FACS) of the following surface antigens on CD19+ lymphocytes in PB (RA and healthy subjects) and SF (RA): CD5, CD23, CD38. Autoantibodies (anti-CCP, RF-IgM and IgA), clinical (swollen joint count, tender joint count) and laboratory examination (ESR, CRP) were analyzed in our cohort. Disease activity was measured using DAS44 (disease activity score). Results: RA patients had decreased CD19 (8.8±5.2%) and CD5 expression (9.1±8.3) on B cells of PB, and a trend for increased circulating CD19+/CD23+ population (40.0±12.6%) relative to healthy subjects (CD19: 12.3±3.9%, p=0.01 vs RA; CD5: 14.8±9.7%, p=0.05 vs RA; CD23: 32.9±6.2%, p=0.17 vs RA). The expression of CD38 in CD19+ cells was similar in PB of patients and healthy subjects. There were not differences regarding the surface markers between Early RA (ERA, disease duration < one year) and Long-standing RA (LSRA) patients. In RA patients, the percentages of CD19+ cells was significantly lower in SF (1.6±1.7%, p<0.01 vs PB) than in PB. In SF we found a higher percentage of CD19+/CD23- cells (90.8±6.5%, p<0.001 vs PB) than in PB. No differences were seen in CD5 and CD38 expression on CD19+ cells between PB and SF. We found a significant correlation between the percentage of CD5 and CD23 positive B cells both in PB (r=0.50, p=0.03) as well as in SF (r=0.78, p=0.003). No relationship arose between disease activity (DAS44, ESR, CRP) and the different subsets of B cells. A positive correlation was observed between the percentage of CD5 B cells and RF-IgM titres (r=0.51, p=0.03) as well as between CD19+ cells and anti-CCP autoantibodies levels (r =0.44, p=0.01). Conclusion: In RA, B cells and Bm1 subset are decreased in PB compared to HBD. In the synovial compartment, activated B cells are decreased compared to PB. This suggests a compartment distribution of B cells and B cell subsets.
CD19+ cells subsets (CD5, CD38 and CD23) in peripheral blood and synovial fluid of rheumatoid arthritis patients: relationship with disease activity and with auto-antibody levels
Gremese E;
2008-01-01
Abstract
Background: B cells arose as important players in the pathogenesis of Rheumatoid Arthritis (RA). Objectives: To define the phenotypic subsets of CD19+ cells in RA patients in the peripheral blood (PB) as well as in the synovial compartment and to correlate them with clinical and biological characteristics. Methods: Thirteen healthy subjects and 33 RA patients (18 females and 15 males, mean age 57.6±12.7years, mean disease duration 6.1± 6.4 years) were analyzed for the expression by flow-cytometry (FACS) of the following surface antigens on CD19+ lymphocytes in PB (RA and healthy subjects) and SF (RA): CD5, CD23, CD38. Autoantibodies (anti-CCP, RF-IgM and IgA), clinical (swollen joint count, tender joint count) and laboratory examination (ESR, CRP) were analyzed in our cohort. Disease activity was measured using DAS44 (disease activity score). Results: RA patients had decreased CD19 (8.8±5.2%) and CD5 expression (9.1±8.3) on B cells of PB, and a trend for increased circulating CD19+/CD23+ population (40.0±12.6%) relative to healthy subjects (CD19: 12.3±3.9%, p=0.01 vs RA; CD5: 14.8±9.7%, p=0.05 vs RA; CD23: 32.9±6.2%, p=0.17 vs RA). The expression of CD38 in CD19+ cells was similar in PB of patients and healthy subjects. There were not differences regarding the surface markers between Early RA (ERA, disease duration < one year) and Long-standing RA (LSRA) patients. In RA patients, the percentages of CD19+ cells was significantly lower in SF (1.6±1.7%, p<0.01 vs PB) than in PB. In SF we found a higher percentage of CD19+/CD23- cells (90.8±6.5%, p<0.001 vs PB) than in PB. No differences were seen in CD5 and CD38 expression on CD19+ cells between PB and SF. We found a significant correlation between the percentage of CD5 and CD23 positive B cells both in PB (r=0.50, p=0.03) as well as in SF (r=0.78, p=0.003). No relationship arose between disease activity (DAS44, ESR, CRP) and the different subsets of B cells. A positive correlation was observed between the percentage of CD5 B cells and RF-IgM titres (r=0.51, p=0.03) as well as between CD19+ cells and anti-CCP autoantibodies levels (r =0.44, p=0.01). Conclusion: In RA, B cells and Bm1 subset are decreased in PB compared to HBD. In the synovial compartment, activated B cells are decreased compared to PB. This suggests a compartment distribution of B cells and B cell subsets.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
