Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China.
Front Immunol. 2024 Sep 3;15:1447213. doi: 10.3389/fimmu.2024.1447213. eCollection 2024.
Rheumatoid arthritis (RA) is an autoimmune disease with various subtypes. Among these, seronegative rheumatoid arthritis (SnRA), distinguished by its distinctive seronegative antibody phenotype, presents clinical diagnosis and treatment challenges. This study aims to juxtapose the immunological features of SnRA with seropositive rheumatoid arthritis (SpRA) to investigate potential mechanisms contributing to differences in antibody production.
This study included 120 patients diagnosed with RA and 78 patients diagnosed with psoriatic arthritis (PsA), comprising 41 cases of SnRA and 79 cases of SpRA. Clinical, serological, and immune data were collected from all participants to systematically identify and confirm the most pivotal immunological distinctions between SnRA and SpRA.
(1) SpRA demonstrates more pronounced T-helper 17 cells (Th17)/Regulatory T cells (Treg) dysregulation, vital immunological differences from SnRA. (2) SpRA exhibits higher inflammatory cytokine levels than SnRA and PsA. (3) Lymphocyte subset ratios and cytokine overall distribution in SnRA close to PsA. (4) Interleukin-4 (IL-4) emerges as the central immunological disparity marker between SnRA and SpRA.
Th17/Treg imbalance is one of the vital immunological disparities between SnRA and SpRA. Interestingly, PsA and SnRA display similar peripheral blood immunological profiles, providing immunological evidence for these two diseases' clinical and pathological similarities. Furthermore, IL-4 emerges as the central immunological disparity marker between SnRA and SpRA, suggesting its potential role as a triggering mechanism for differential antibody production.
类风湿关节炎（RA）是一种自身免疫性疾病，具有多种亚型。其中，血清阴性类风湿关节炎（SnRA）以其独特的血清阴性抗体表型为特征，在临床诊断和治疗方面带来挑战。本研究旨在比较 SnRA 与血清阳性类风湿关节炎（SpRA）的免疫学特征，以探讨导致抗体产生差异的潜在机制。
本研究纳入了 120 例 RA 患者和 78 例银屑病关节炎（PsA）患者，包括 41 例 SnRA 和 79 例 SpRA。对所有参与者进行临床、血清学和免疫数据采集，以系统地确定和确认 SnRA 和 SpRA 之间最关键的免疫学差异。
（1）SpRA 表现出更明显的辅助性 T 细胞 17（Th17）/调节性 T 细胞（Treg）失调，这是与 SnRA 的重要免疫学差异。（2）SpRA 表现出比 SnRA 和 PsA 更高的炎症细胞因子水平。（3）SnRA 的淋巴细胞亚群比例和细胞因子总体分布与 PsA 相似。（4）白细胞介素-4（IL-4）成为 SnRA 和 SpRA 之间的中心免疫学差异标志物。
Th17/Treg 失衡是 SnRA 和 SpRA 之间的重要免疫学差异之一。有趣的是，PsA 和 SnRA 表现出相似的外周血免疫学特征，为这两种疾病的临床和病理相似性提供了免疫学证据。此外，IL-4 成为 SnRA 和 SpRA 之间的中心免疫学差异标志物，表明其可能作为差异抗体产生的触发机制。
