Gernert Michael, Müller Tobias, Schweiker Lukas, Schmalzing Marc, Fröhlich Matthias, Nagler Lea-Kristin, Strunz Patrick-Pascal, Labinsky Hannah, Schwaneck Eva Christina
Department of Medicine II, Rheumatology and Clinical Immunology, University Hospital of Würzburg, Oberdürrbacher Str. 6, D-97080, Würzburg, Germany.
Chair of Bioinformatics, University of Würzburg, Am Hubland, D-97074, Würzburg, Germany.
Arthritis Res Ther. 2024 Dec 11;26(1):210. doi: 10.1186/s13075-024-03444-0.
Clonal T cell populations are frequently detected in patients with rheumatic diseases. The relevance of this finding is often uncertain, as the clinical spectrum can range from being asymptomatic to T cell leukemia. Former studies suggested that certain anti-rheumatic drugs might influence the course of the clonal T cell populations.
A prospective long-term follow up study was performed including patients with rheumatic diseases and clonal T cell populations. Clinical features, adverse events, especially infections and cytopenias, and immunosuppressive medication were assessed. T cell populations were characterized by polymerase chain reaction, flow cytometry and stimulated cell cultures.
28 Patients with rheumatoid arthritis, spondyloarthritis, or giant cell arteritis were prospectively followed for up to 7.6 years. Severe infections or cytopenias (10.7% autoimmune neutropenias) were rare. The clonal T cell populations mostly persisted over time, the tumor burden decreased in the long-term. The cytokine secretion in stimulated T cell cultures did not differ in the subgroup of RA patients with versus without clonal T cells.
Clonal T cell populations in patients with rheumatic diseases are common, but are rarely harmful. Feared neutropenia, infections or progression into T cell leukemia could not be detected in the long-term in our cohort.
在风湿性疾病患者中经常检测到克隆性T细胞群体。这一发现的相关性往往不确定，因为临床谱范围可从无症状到T细胞白血病。既往研究提示某些抗风湿药物可能会影响克隆性T细胞群体的病程。
对患有风湿性疾病和克隆性T细胞群体的患者进行了一项前瞻性长期随访研究。评估临床特征、不良事件，尤其是感染和血细胞减少症，以及免疫抑制药物的使用情况。通过聚合酶链反应、流式细胞术和刺激细胞培养对T细胞群体进行特征分析。
对28例类风湿关节炎、脊柱关节炎或巨细胞动脉炎患者进行了长达7.6年的前瞻性随访。严重感染或血细胞减少症（10.7%为自身免疫性中性粒细胞减少症）较为罕见。克隆性T细胞群体大多随时间持续存在，长期来看肿瘤负荷降低。在有克隆性T细胞和无克隆性T细胞的类风湿关节炎患者亚组中，刺激T细胞培养物中的细胞因子分泌没有差异。
风湿性疾病患者中的克隆性T细胞群体很常见，但很少有害。在我们的队列中，长期未检测到令人担忧的中性粒细胞减少症、感染或进展为T细胞白血病的情况。
