Introduction
Patients and methods
Retrospective study | Prospective cohort | |
---|---|---|
Number of patients (female/male) | 94 (73/14) | 70 (53/17) |
Age at disease onset (years) [mean (range)] | 45.8 (20–77) | 51.9 (19–74) |
Disease duration (years) [mean (range)] | 16.7 (1.4–61) | 4.44 (4.1–6.7) |
ESR (mm/h) [mean (range)] | 34.2 (2–100) | 23.8 (3–76) |
C-reactive protein (mg/l) [mean (range)] | 34.3 (0–190) | 13.1 (0–116.5) |
Patients positive for RF IgM [n (%)] | 51 (54.3) | 42 (60) |
RF IgM concentration (IU/ml) [mean (range)] | 344.6 (0–3680) | 245.2 (0–3430) |
Patients positive for RF IgA [n (%)] | 52 (55.3) | 3 (48.6) |
RF IgA concentration (IU/ml) [mean (range)] | 105.6 (0–600) | 71.8 (0–600) |
Patients positive for ANF [n (%)] | 56 (59.5) | 55 (78.6) |
Extra-articular manifestations | ||
Rheumatoid nodules [n (%)] | 28 (29.8) | 5 (7.1) |
Keratokonjunctivitis sicca [n (%)] | 30 (32) | 10 (14.3) |
Polyserositis [n (%)] | 2 (2.1) | 0 |
Interstitial pulmonary fibrosis [n (%)] | 1 (1.1) | 0 |
Immunogenetics | ||
DRB1*01+ [n (%)] | 21 (22) | 19 (27.1) |
SE+ DR4+ [n (%)] | 46 (49) | 32 (45.7) |
SE+ DR4+ homozygotes [n (%)] | 15 (16.0) | 8 (11.4) |
SE+ [n (%)] | 67 (71) | 51 (72.8) |
SE compound homozygotes [n (%)] | 24 (25.5) | 12 (17.1) |
Therapy | ||
Methotrexate | 57 | 56 |
Cyclosporine A | 9 | 6 |
Azathioprine | 6 | 0 |
Chlorochine/sulfasalazine/gold salts intramuscularly | 6 | 5 |
Cyclophosphamide | 7 | 0 |
No DMARD | 9 | 7 |
Number of DMARD used [mean (range)] | 2 (0–5) | 1 (0–3) |
Results
The frequency of CD19+ B cells is dependent on HLA DRB1
Absolute B-cell counts prospectively analyzed in RA patients
Characterization of patients with diminished numbers of CD19+ B cells
CD19high patients (n = 33) | CD19low patients (n = 37) | |
---|---|---|
Disease duration (years) | 6.54 | 6.68 |
MTX at time of analysis [n (%)] | 26 (78.8) | 30 (81.1) |
MTX dose (mg) [mean (range)] | 15.4 (15–20) | 16.1 (15–20) |
MTX in combination with cyclosporine A | 2 | 3 |
Duration of MTX therapy (months) | 40.1 | 43.3 |
MTX-treated patients positive for SE [n (%)] | 22 (66.7) | 19 (51.3) |
Tauredon therapy | 1 | 2 |
Cyclosporine A | 1 | 1 |
Chloroquine | 2 | 0 |
Prednisolone at time of analysis (mg) | 4.8 | 4.8 |
Dose range (mg) | 3–10 | 3–7 |
Discussion
Conclusion
Supplementary material
Supplementary Materials and methods
Supplementary Results
Descriptive analysis of lymphocyte subpopulations
CD4+ | CD4+CD45RA+ | Lymphocytes | Monocytes | |
---|---|---|---|---|
CD19+ | ||||
R |
0.422
| 0.233 |
0.512
| -0.098 |
P |
0.0003
| 0.054 |
< 0.0001
| 0.445 |
CD4+
| ||||
P |
0.808
|
0.677
| 0.061 | |
R |
< 0.0001
|
< 0.0001
| 0.634 |
Clinical description of CD19low and CD19high patients
CD19low group | CD19high group | Level of significance | |
---|---|---|---|
Retrospective study group | n = 58 | n = 36 | |
Age (years) | 63.8 (56–72) | 62.7 (56–72) | 0.613 |
Disease duration (years) | 11.4 (7.1–22.6) | 19 (5.8–27.7) | 0.446 |
ESR (mm/h) | 35.9 (22.83–3.19) | 31.52 (21.72–3.9) | 0.393 |
C-reactive protein (mg/l) | 27.6-(6.5–60) | 15.7 (7.18–40.28 | 0.204 |
Serum IgM (g/l) | 1.65 (1.20–2.26) | 1.92 (1.60–2.61) | 0.022 |
Serum IgG (g/l) | 10.45 (9.09–11.70) | 10.50 (9.54–13.00) | 0.498 |
Serum IgA (g/l) | 2.67 (1.89–3.73) | 2.67 (1.88–3.91) | 0.724 |
RF IgM (IU/ml) | 134.8 (84–257) | 187 (110–207) | 0.182 |
RF IgA 9 IU/ml) | 75 (33.5–128.75) | 31.5 (13.5–106.5) | 0.02 |
ANF (titer) | 1:160 (0–1:320) | 1:160 (0–1:1120) | 0.861 |
Circulating immune complexes(g/l) | 4.6 (3.32–9.15) | 4.45 (3–5.8) | 0.607 |
Prospective study group | n = 36 | n = 34 | |
C-reactive protein (mg/l) | 14 (5–25.5) | 5.4 (0–9.2) | 0.013 |
Serum IgM (g/l) | 1.07 (0.79–1.4) | 1.19 (0.88–1.43) | 0.618 |
Serum IgG (g/l) | 11.5 (10.22–13.7) | 12.7 (11–14.2) | 0.371 |
Serum IgA (g/l) | 3.08 (2.04–3.86) | 2.35 (1.78–3.02) | 0.062 |
RF IgM (IU/ml) | 132 (31.1–253) | 65.5 (0–136) | 0.099 |
RF IgA (IU/ml) | 63.5 (12–155.8) | 0 (0–8) | < 0.001 |