Abstract
Presence of autoantibodies precedes development of seropositive rheumatoid arthritis (SP RA) and seropositive arthralgia patients (SAP) are at risk of developing RA. The aims of the study are to identify additional serum immune markers discriminating between SP and seronegative (SN) RA, and markers identifying high-risk SAP. Sera from SAP (n = 27), SP RA (n = 22), SN RA (n = 11) and healthy controls (n = 20) were analyzed using the Human Cytokine 25-Plex Panel. Selected markers were validated in independent cohorts of SP RA (n = 35) and SN RA (n = 12) patients. Eleven of 27 SAP developed RA within 8 months (median follow-up time, range 1–32 months), and their baseline serum markers were compared to 16 non-progressing SAP. SAP and SP RA patients showed a marked overlap in their systemic immune profiles, while SN RA showed a distinct immune profile. Three of 4 markers discriminating between SP and SN RA (IL-1β, IL-15 and Eotaxin, but not CCL5) were similarly modulated in independent cohorts. SAP progressing to RA showed trends for increases in IL-5, MIP-1β, IL-1RA and IL-12 compared to non-progressing SAP. ROC analysis showed that serum IL-5 most accurately discriminated between the two SAP groups (AUC > 0.8), suggesting that baseline IL-5 levels may aid the identification of high-risk SAP.
Highlights
Erosive disease[15,16,17,18,19,20]
We investigated whether the baseline serum markers differed between seropositive arthralgia patients (SAP) who progressed to Rheumatoid arthritis (RA) (SAP = >RA, median time to arthritis development was 8 [range 1–32] months) and SAP who did not progress to RA during the follow-up period
The aims of the present study were to compare serum immune markers for their ability to discriminate between early SP and SN RA; and to identify serum immune markers that may predict progression to RA in SAP
Summary
Erosive disease[15,16,17,18,19,20]. SP RA patients have a greater need for disease-modifying anti-rheumatic drugs (DMARDs) or aggressive treatment[16,17] and a lower chance of achieving drug-free remission[20,21]. Presence of ACPA or RF has been associated with the development of comorbidities, such as vasculitis[22] and pulmonary diseases[23]. We aimed to identify serum immune markers that could discriminate between recently diagnosed SP RA and SN RA patients.
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