Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Front Immunol. 2021 Oct 15;12:744254. doi: 10.3389/fimmu.2021.744254. eCollection 2021.
Patients with rheumatoid arthritis (RA) have a significantly high risk of atrial fibrillation (AF). This study aimed to compare the absolute and relative changes in peripheral T cells in patients with RA who were also affected with and without AF. To help make an early diagnosis and prevent the initiation and progression of AF, the changes in the lymphocyte subsets were assessed in RA patients with and without AF. A propensity score matching (PSM) system (1:3) was used to perform a matched case-control study with 40 RA-AF cases and 120 RA controls. Changes in the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-citrullinated peptide antibody (ACPA), and rheumatoid factor (RF) were examined. The percentage and absolute number of T, B, natural killer (NK), T helper (Th)1, Th2, Th17, and T-regulatory (Treg) cells in the peripheral blood of patients with and without RA-AF were determined using flow cytometry. Univariate and multivariate analyses were performed to determine the association between peripheral lymphocytes and RA-AF. Demographic data, ESR, CRP, ACPA, and the percentage, as well as the absolute value of B, NK, Th2, and Treg cells, showed no significant differences between the propensity score-matched groups of RA and RA-AF. Meanwhile, the absolute number and percentage of Th1 cells, the absolute number of Th17 cells, the ratio of Th1/Treg, Th17/Treg, and RF were significantly higher in patients with RA-AF than those in the control groups (P < 0.05). Univariate and multivariate logistic regression analyses also revealed that the percentage of Th1 cells, the absolute number of Th17 cells, and the ratio of Th1/Treg were associated with a significantly higher risk of AF. This PSM study demonstrated that the incidence of AF was higher in RA patients with Th cell immunological derangements.
类风湿关节炎（RA）患者发生心房颤动（AF）的风险显著增高。本研究旨在比较合并和不合并 AF 的 RA 患者外周 T 细胞的绝对和相对变化。通过评估 RA 患者伴或不伴 AF 时淋巴细胞亚群的变化，有助于早期诊断并预防 AF 的发生和进展。采用倾向性评分匹配（PSM）系统（1:3）对 40 例 RA-AF 病例和 120 例 RA 对照进行匹配病例对照研究。检查红细胞沉降率（ESR）、C 反应蛋白（CRP）、抗瓜氨酸肽抗体（ACPA）和类风湿因子（RF）的变化。采用流式细胞术检测 RA 患者和 RA-AF 患者外周血中 T、B、自然杀伤（NK）、辅助性 T 细胞 1（Th1）、Th2、Th17 和调节性 T（Treg）细胞的百分比和绝对数。采用单因素和多因素分析来确定外周淋巴细胞与 RA-AF 之间的关系。在匹配后的 RA 和 RA-AF 组之间，人口统计学数据、ESR、CRP、ACPA 以及 B、NK、Th2 和 Treg 细胞的百分比和绝对值均无显著差异。同时，RA-AF 患者 Th1 细胞的绝对数和百分比、Th17 细胞的绝对数、Th1/Treg、Th17/Treg 和 RF 的比值显著高于对照组（P<0.05）。单因素和多因素 logistic 回归分析也表明，Th1 细胞的百分比、Th17 细胞的绝对数和 Th1/Treg 的比值与 AF 发生的风险显著增加相关。这项 PSM 研究表明，伴有 Th 细胞免疫紊乱的 RA 患者发生 AF 的风险更高。
