Abstract

Background:The study of the ability of monocytes to activate associated with the clinical activity of immunological markers of inflammation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) will provide important and fundamentally new information on the involvement of these cells in the development of autoimmune rheumatic diseases (ARDs).Objectives:To study macrophage activation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (pts).Methods:A total of 21 active ARDs pts (11 RA, 10 SLE) were enrolled in the study (median age was 55[44; 63] years; disease duration was 8 [2; 14] months). There are 11 pts with early RA (disease duration was ≤12 months), moderate to high activity (DAS28 was 6.1[4.9;6.7]; SDAI was 25(22;31); ACCP was positive in 73% and RF in 87% cases) and 10 pts with active SLE (SLADAI-2K was 7 [6;8]) in the study. All early RA pts and 4 SLE pts were not treated with glucocorticoids and disease-modifying antirheumatic drugs. Six SLE pts received low-dose glucocorticoids and hydroxychloroquine.All pts were assessed for macrophage activation and laboratory data: ESR, RF, ACCP, CRP, ANA, anti-dsDNA. Isolation of monocytes was carried out according to the standard procedure for obtaining a leukocyte fraction in a Ficoll gradient and subsequent selection of CD14 + cells using magnetic separation. After isolation, the cells were cultured in X-Vivo medium. To assess the degree of monocyte activation, cells were stimulated by the addition of LPS. The value of monocyte activation was expressed as a ratio of the level of secretion of proinflammatory cytokines by monocytes cultured with and without LPS addition. Secretion levels were determined by ELISA. The belonging of the isolated cells to CD14 + monocytes was additionally confirmed by flow cytometry.Results:Macrophage activation was 2.6 (2.0;5.4) and 4.8 (2.8;7.3) in RA and SLE pts, respectively (p>0.05). In RA and SLE pts macrophage activation was independent of age, sex, body mass index, traditional risk factors (arterial hypertension, overweight, smoking, family history of cardiovascular diseases), RA activity scores (DAS28, SDAI), and SLADAI-2K. No association was found between macrophage activation and levels of ESR, RF, ACCP, CRP, ANA, and anti-dsDNA.Conclusion:No differences in macrophage activation were found in RA and SLE pts. Macrophage activation was independent of age, sex, traditional risk factors, and ARD-related parameters. A study on a larger number of pts will clarify the link between macrophage activation and autoimmune disorders.This work was supported by the Russian Science Foundation (Grant № 21-15-00225).Disclosure of Interests:None declared

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