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Abstract
Circulating CD45−CD31−PDPN+ pre-inflammatory mesenchymal (PRIME) cells, which share features with inflammatory synovial fibroblasts, increase 1–2 weeks before rheumatoid arthritis flares, according to a longitudinal RNA sequencing study by Dana Orange and colleagues. Home-collected fingerstick blood samples were assessed from one patient at 364 time points over the course of 4 years, as well as from 235 time points in three additional patients, to identify transcripts that were differentially expressed before and during flares. Consistent changes in transcriptional profiles were observed 1–2 weeks before rheumatoid arthritis flares indicating B cell activation followed by expansion of circulating PRIME cells. Levels of circulating PRIME cells decreased during flares, suggesting migration into the synovium. PRIME cells were also found to occur more frequently in blood samples of 19 additional patients with rheumatoid arthritis compared with those of healthy controls.
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