Abstract
Immune regulation status may indicate immunological remission in rheumatoid arthritis (RA). This cross-sectional study aimed to determine the Regulatory T cell (Treg) properties, together with 14 plasma cytokines levels between active RA and clinical remission patients. Peripheral blood (PB) Foxp3+ Treg was collected from RA patients for determination of Treg inhibitory activity using a co-culture system. Other PB T cell types and plasma cytokines were determined by flow-cytometry. The Treg results were analyzed according to the disease activity score-28 (DAS28). Then sensitivity and specificity were calculated for the indication of the remission status. The number and inhibitory activity of Treg are higher in the clinical remission as compared to the active RA (p value < 0.0001). Also, Treg: CD4+CD25+CD127+ cell ratio demonstrates the similar result (p value < 0.05). Treg inhibitory activity is inversely correlated with the DAS28. Specificity and positive likelihood ratio of inhibitory activity for indicating remission status are 92.31% (95% CI 63.97–99.81) and 11.14 (95% CI 1.67–74.14), respectively. Treg inhibitory activity is a promising prognostic marker and probably represents the immunological remission status in RA.
Highlights
Rheumatoid arthritis (RA) is a systemic autoimmune disease, manifesting mainly as joint inflammation
There was no statistical difference in disease activity score-28 (DAS28) score between the negative vs positive serology patients (2.3 ± 0.7 vs 3.2 ± 1.4, p value = 0.111), especially when separated the patients based on DAS28 score as described above
This study shows that the number of peripheral blood Foxp3+ Treg cells is significantly lower in clinically active as compared to remission rheumatoid arthritis (RA) patients while both demonstrate lower quantity than that of the healthy controls, which is in accordance with the other s tudies[5]
Summary
Rheumatoid arthritis (RA) is a systemic autoimmune disease, manifesting mainly as joint inflammation. Immunological remission may reflect a condition of restored immunological status, e.g. normal cytokines level and response of inflammatory cells. In seropositive RA, rheumatoid factor (RF) could turn to be negative after controlled inflammation, anti-citrullinated protein antibodies (ACPA) is always positive even after clinical remission. Its number is decreased among patients in RA active s tate[4,5], but Treg numbers do not indicate the balance in immune status because of cytokine-T cell plasticity[6]. To display the whole immunological tolerance status, this study measured Foxp3+ Treg inhibitory activity, frequencies of Foxp3+ Treg and effector T cell, and cytokine levels from peripheral blood of clinical remission RA and active state RA patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
