Department of Laboratory Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Department of Rheumatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
J Orthop Surg Res. 2021 Dec 20;16(1):732. doi: 10.1186/s13018-021-02883-8.
Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters.
In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction.
The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing RA was 0.831 (95% CI 0.748 ~ 0.915), the specificity was 91.4%, and the sensitivity was 67.5%. The AUC predicted by the combination of plasmablast and anti-CCP for active RA patients was 0.760, which was higher than that of plasmablast and anti-CCP.
In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA.
自身抗体的产生是类风湿关节炎（RA）炎症的主要危险因素。本研究旨在探讨 RA 患者 B 淋巴细胞亚群（天然 B 细胞、记忆 B 细胞和浆母细胞）和几种细胞因子的差异及其与临床参数的相关性。
本研究共纳入 2018 年 9 月至 2020 年 10 月期间的 81 例 RA 患者（活动期 RA 和缓解期 RA）和 40 名健康对照者。采用流式细胞术检测外周血 B 淋巴细胞亚群分布，酶联免疫吸附试验检测血浆细胞因子。采用受试者工作特征曲线（ROC）评估各指标对 RA 诊断和活动预测的价值。
RA 患者天然 B 细胞和记忆 B 细胞的比例与健康对照组无显著差异。然而，活动期 RA 患者浆母细胞的比例明显高于健康对照组和缓解期 RA 患者。浆母细胞的比例与 C 反应蛋白显著相关。ROC 曲线分析显示，当浆母细胞/B 细胞的最佳截断值为 1.08%时，诊断 RA 的曲线下面积（AUC）为 0.831（95%CI 0.748~0.915），特异性为 91.4%，敏感性为 67.5%。浆母细胞与抗 CCP 联合预测活动期 RA 患者的 AUC 为 0.760，高于浆母细胞和抗 CCP。
总之，不同阶段 RA 患者浆母细胞的比例不同。浆母细胞的比例可作为 RA 的早期诊断标志物。
