Penatti Alessandra, Facciotti Federica, De Matteis Roberta, Larghi Paola, Paroni Moira, Murgo Antonella, De Lucia Orazio, Pagani Massimiliano, Pierannunzii Luca, Truzzi Marcello, Ioan-Facsinay Andreea, Abrignani Sergio, Geginat Jens, Meroni Pier Luigi
DISCCO-Department of Clinical Science and Community Health Università degli Studi di Milano, 20122, Milan, Italy.
ASST-Gaetano Pini/CTO Orthopedic and Traumatology Specialist Center, Rheumatology and Orthopedic Department, 20122, Milan, Italy.
Arthritis Res Ther. 2017 May 19;19(1):103. doi: 10.1186/s13075-017-1305-1.
The aim was to investigate CD4T-cell subsets, immune cells and their cytokine profiles in blood and synovial compartments in rheumatoid arthritis (RA) and inflammatory osteoarthritis (OA) to define specific immune signatures.
Peripheral blood, synovial fluid (SF) and synovial membranes (SM) of RA and OA patients were analyzed. CD4T-cell subset frequencies were determined by flow cytometry, and cytokine concentrations in serum and SF were measured by ELISA.
In peripheral blood, OA patients had altered frequencies of regulatory T-cell subsets, and higher frequencies of Th17 and of Th1/17 cells than RA patients. In the synovial compartment of OA patients, conventional Th17 cells were largely excluded, while Th1/17 cells were enriched and more frequent than in RA patients. Conversely, in the synovial compartment of RA patients, regulatory T cells and Tfh cells were enriched and more frequent then in OA patients. IL-17 and Blys were increased both in serum and SF of RA patients, and correlated with autoantibodies and disease activity. Notably, Blys levels were already significantly elevated in RA patients with low disease activity score in 28 joints (DAS28) and without autoantibody positivity.
Although patients with inflammatory OA have immune activation in the synovial compartment, they display different T-cell subset frequencies and cytokine profiles. Soluble mediators such as Blys might help to discriminate mild clinical forms of RA from inflammatory OA particularly at the onset of the disease.
目的是研究类风湿关节炎（RA）和炎性骨关节炎（OA）患者血液和滑膜腔室中的CD4 T细胞亚群、免疫细胞及其细胞因子谱，以确定特定的免疫特征。
分析RA和OA患者的外周血、滑液（SF）和滑膜（SM）。通过流式细胞术确定CD4 T细胞亚群频率，通过酶联免疫吸附测定法（ELISA）测量血清和SF中的细胞因子浓度。
在外周血中，OA患者调节性T细胞亚群频率发生改变，且Th17和Th1/17细胞频率高于RA患者。在OA患者的滑膜腔室中，传统Th17细胞大量缺失，而Th1/17细胞富集且比RA患者更常见。相反，在RA患者的滑膜腔室中，调节性T细胞和滤泡辅助性T细胞（Tfh）富集且比OA患者更常见。RA患者血清和SF中的白细胞介素-17（IL-17）和B淋巴细胞刺激因子（Blys）均升高，并与自身抗体和疾病活动相关。值得注意的是，在28个关节疾病活动评分（DAS28）低且无自身抗体阳性的RA患者中，Blys水平已经显著升高。
尽管炎性OA患者滑膜腔室存在免疫激活，但他们表现出不同的T细胞亚群频率和细胞因子谱。Blys等可溶性介质可能有助于区分轻度临床形式的RA和炎性OA，尤其是在疾病发作时。
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