Activating mutations in CD8+ T-cells correlate to serological positivity in rheumatoid arthritis.

OBJECTIVES

Large granular lymphocyte (LGL) leukemia is a rare hematologic malignancy characterized by clonal expansion of cytotoxic T-cells frequent somatic activating mutations. Based on the disease overlap between LGL leukemia rheumatoid arthritis (RA)a putative role for CD8+ T-cells in RA we hypothesized that mutations may be detected in RA patient CD8+ T-cells correlate with clinical characteristics.

METHODS

Blood samples, clinical parameters, and demographics were collected from 98 RA patients and 9 healthy controls (HCs). CD8+ cell DNA was isolated and analyzed via droplet digital (dd)PCR to detect mutations common in LGL leukemia: Y640F, D661Y, and the S614 to G618 region. data from 99 HCs from a public dataset supplemented our 9 HCs.

RESULTS

RA patients had significantly increased presence of mutations compared to controls (Y640F p=0.0005, D661Y p=0.0005). The majority of these were low variant allele frequency (VAF) (0.008-0.05%) mutations detected in a higher proportion of the RA population (31/98 Y640F, 17/98 D661Y) vs. HCs (0/108 Y640F, 0/108 D661Y). In addition, 3/98 RA patients had a mutation at a VAF >5% compared to 0/108 controls. Serological markers, RF and anti-CCP positivity, were more frequently positive in RA patients with mutation relative to those without (88% vs 59% RF, p=0.047; 92% vs 58% anti-CCP, p=0.031, respectively).

CONCLUSIONS

activating mutations were detected in RA patient CD8+ cells and associated with seropositivity. Thus, activating mutations may play a role in disease pathogenesis in a subset of RA patients.