Schwaneck Eva C, Renner Regina, Tony Hans-Peter, Weber Alexander, Geissinger Eva, Gernert Michael, Fröhlich Matthias, Schmalzing Marc, Gadeholt Ottar
Schwerpunkt Rheumatologie/Klinische Immunologie, Medizinische Klinik Und Poliklinik II, Universität Würzburg, Würzburg, Germany.
Sektion Rheumatologie Und Klinische Immunologie, Asklepios Klinik Altona, Paul-Ehrlich-Straße 1, 22763, Hamburg, Germany.
Rheumatol Int. 2021 Nov;41(11):1979-1986. doi: 10.1007/s00296-021-04872-w. Epub 2021 May 15.
To determine the prevalence of clonal T-large granular lymphocyte (T-LGL) cells in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA) and to define possible risk factors for this condition. We present a cross-sectional analysis with retrospective and prospective aspects. 115 SpA patients, 48 PsA patients and 51 controls were recruited between December 28, 2017 and January 23, 2019. Flow cytometry (FACS) was performed to screen for aberrant T-LGL cells. Molecular analysis was then employed to confirm the diagnosis in patients with suggestive FACS findings. Patients with clonal T-LGL populations were followed prospectively by FACS analysis. Electronic patient files were retrospectively analyzed to determine risk factors. Median age was 49 years for SpA, 55.5 years for PsA, and 54 years for controls. Median disease duration of SpA and PsA was 15 years and 11 years, respectively. 79.8% of patients had received biologics at some point, 75.5% had ever received tumor necrosis factor (TNF) inhibitors. 59.5% were treated with TNF inhibitors at the time of study inclusion. We identified clonal T-LGL expansions in 13 individuals equaling a prevalence of 6% (13/214). T-LGL patients were taking TNF inhibitors more frequently at the time of study inclusion (p = 0.022) and were more likely to have ever been treated with TNF inhibition (p = 0.046). Clonal T-LGL expansions can be detected in patients with SpA, PsA and also in healthy controls. Confirming earlier results, exposure to TNFα-blocking agents appears to increase the risk of developing clonal expansions of T-LGL cells.
确定脊柱关节炎（SpA）和银屑病关节炎（PsA）患者中克隆性T大颗粒淋巴细胞（T-LGL）细胞的患病率，并明确该病症可能的危险因素。我们进行了一项兼具回顾性和前瞻性的横断面分析。在2017年12月28日至2019年1月23日期间招募了115例SpA患者、48例PsA患者和51名对照者。采用流式细胞术（FACS）筛查异常T-LGL细胞。然后对FACS结果提示的患者进行分子分析以确诊。对具有克隆性T-LGL群体的患者通过FACS分析进行前瞻性随访。对电子病历进行回顾性分析以确定危险因素。SpA患者的中位年龄为49岁，PsA患者为55.5岁，对照者为54岁。SpA和PsA的中位病程分别为15年和11年。79.8%的患者曾在某个时间点接受过生物制剂治疗，75.5%曾接受过肿瘤坏死因子（TNF）抑制剂治疗。在纳入研究时，59.5%的患者正在接受TNF抑制剂治疗。我们在13名个体中发现了克隆性T-LGL扩增，患病率为6%（13/214）。T-LGL患者在纳入研究时更频繁地使用TNF抑制剂（p = 0.022），并且更有可能曾接受过TNF抑制治疗（p = 0.046）。在SpA、PsA患者以及健康对照者中均可检测到克隆性T-LGL扩增。与早期结果一致，接触TNFα阻断剂似乎会增加发生T-LGL细胞克隆性扩增的风险。
