采用 MRI 弛豫率和黏膜相关不变 T 细胞评估中轴型脊柱关节炎患者的炎症活动度。
Inflammatory activity evaluation in patients with axial spondyloarthritis using MRI relaxometry and mucosal-associated invariant T cells.
机构信息
Shengli Clinical Medical College of Fujian Medical University, Fujian, Fuzhou, China.
Department of Radiology, Fujian Provincial Hospital, Fujian, Fuzhou, China.
出版信息
Front Immunol. 2024 May 22;15:1391280. doi: 10.3389/fimmu.2024.1391280. eCollection 2024.
BACKGROUND
Currently, there is a lack of an objective quantitative measure to comprehensively evaluate the inflammatory activity of axSpA, which poses certain challenges in accurately assessing the disease activity.
OBJECTIVE
To explore the value of combined-parameter models of sacroiliac joints (SIJs) MRI relaxometry and peripheral blood Mucosal-associated invariant T (MAIT) cells in evaluating the inflammatory activity of axial spondyloarthritis (axSpA).
METHODS
This retrospective clinical study included 88 axSpA patients (median age 31.0 (22.0, 41.8) years, 21.6% females) and 20 controls (median age 28.0 (20.5, 49.5) years, 40.0% females). The axSpA group was classified into active subgroup (n=50) and inactive subgroup (n=38) based on ASDAS-CRP. All participants underwent SIJs MRI examination including T1 and T2* mapping, and peripheral blood flow cytometry analysis of MAIT cells (defined as CD3Vα7.2CD161) and their activation markers (CD69). The T1 and T2* values, as were the percentages of MAIT cells and CD69MAIT cells were compared between different groups. Combined-parameter models were established using logistic regression, and ROC curves were employed to evaluate the diagnostic efficacy.
RESULTS
The T1 values of SIJs and %CD69MAIT cells in the axSpA group and its subgroup were higher than the control group (p<0.05), while %MAIT cells were lower than the control group (p<0.05). The T1 values and %CD69MAIT cells correlated positively, while %MAIT cells correlated negatively, with the ASDAS-CRP (r=0.555, 0.524, -0.357, p<0.001). Between the control and axSpA groups, and between the inactive and active subgroups, the combined-parameter model T1 mapping+%CD69MAIT cells has the best efficacy (AUC=0.959, 0.879, sensibility=88.6, 70%, specificity=95.0, 94.7%, respectively).
CONCLUSION
The combined-parameter model T1 mapping+%CD69MAIT cells allows a more accurate evaluation of the level of inflammatory activity.
背景
目前，缺乏一种客观的定量方法来全面评估 axSpA 的炎症活动，这给准确评估疾病活动带来了一定的挑战。
目的
探讨骶髂关节（SIJ）MRI 弛豫度和外周血黏膜相关不变 T（MAIT）细胞联合参数模型在评估轴性脊柱关节炎（axSpA）炎症活动中的价值。
方法
本回顾性临床研究纳入了 88 例 axSpA 患者（中位年龄 31.0（22.0，41.8）岁，21.6%为女性）和 20 名对照者（中位年龄 28.0（20.5，49.5）岁，40.0%为女性）。根据 ASDAS-CRP，将 axSpA 组分为活动亚组（n=50）和非活动亚组（n=38）。所有参与者均接受 SIJ MRI 检查，包括 T1 和 T2* 成像，以及外周血 MAIT 细胞（定义为 CD3Vα7.2CD161）及其激活标志物（CD69）的流式细胞术分析。比较不同组间 SIJ 的 T1 和 T2* 值以及 MAIT 细胞和 CD69MAIT 细胞的百分比。使用逻辑回归建立联合参数模型，并采用 ROC 曲线评估诊断效能。
结果
axSpA 组及其亚组的 SIJ T1 值和%CD69MAIT 细胞高于对照组（p<0.05），而 MAIT 细胞百分比低于对照组（p<0.05）。T1 值和%CD69MAIT 细胞与 ASDAS-CRP 呈正相关（r=0.555，0.524，p<0.001），而 MAIT 细胞与 ASDAS-CRP 呈负相关（r=-0.357，p<0.001）。在对照组与 axSpA 组之间，以及在非活动亚组与活动亚组之间，T1 映射+%CD69MAIT 细胞联合参数模型的效能最佳（AUC=0.959，0.879，敏感性=88.6%，特异性=95.0%；AUC=0.879，0.700，敏感性=70%，特异性=94.7%）。
结论
T1 映射+%CD69MAIT 细胞联合参数模型可更准确地评估炎症活动水平。
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