Abstract

PD-1 plays a crucial role in the immune dysregulation of rheumatoid arthritis (RA), but the specific characteristics of PD-1+CD4+ Tcells remain unclear and require further investigation. Circulating PD-1+CD4+ Tcells from RA patients were analysed using flow cytometry. Plasma levels of soluble PD-1 (sPD-1) were measured using enzyme-linked immunosorbent assay (ELISA). Single-cell RNA sequence data from peripheral blood mononuclear cells (PBMCs) and synovial tissue of patients were obtained from the GEO and the ImmPort databases. Bioinformatics analyses were performed in the R studio to characterise PD-1+CD4+ Tcells. Expression of CCR7, KLF2 and IL32 in PD-1+CD4+ Tcells was validated by flow cytometry. RA patients showed an elevated proportion of PD-1+CD4+ Tcells in peripheral blood, along with increased plasma sPD-1 levels, which positively correlated with TNF-α and erythrocyte sedimentation rate. Bioinformatic analysis revealed PD-1 expression on CCR7+CD4+ Tcells in PBMCs, and on both CCR7+CD4+ Tcells and CXCL13+CD4+ Tcells in RA synovium. PD-1 was co-expressed with CCR7, KLF2, and IL32 in peripheral CD4+ Tcells. In synovium, PD-1+CCR7+CD4+ Tcells had higher expression of TNF and LCP2, while PD-1+CXCL13+CD4+ Tcells showed elevated levels of ARID5A and DUSP2. PD-1+CD4+ Tcells in synovium also appeared to interact with B cells and fibroblasts through BTLA and TNFSF signalling pathways. This study highlights the increased proportion of PD-1+CD4+ Tcells and elevated sPD-1 levels in RA. The transcriptomic profiles and signalling networks of PD-1+CD4+ Tcells offer new insights into their role in RA pathogenesis.

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