Abstract
BackgroundImbalance and disfuntion in regulatory T-cells (Tregs) and IL-17 producer lymphocytes (Th17) have been implicated in the pathogenesis of rheumatoid arthritis (RA). Gray scale synovial proliferation (GS), power Doppler signal (pD) and bone erosions seen on high resolution muskuloskeletal ultrasound (MSUS) are hallmarks of destructive articular disease.ObjectiveTo evaluate the association of peripheral Tregs and Th17 with MSUS findings in RA.MethodsRA patients (1987 ACR criteria) treated with disease-modifying antirheumatic drugs (DMARDs) were included. Lymphocytes were isolated and immunophenotyped by flow cytometry to investigate regulatory FoxP3+ T cells and IL-17+ cells. MSUS (MyLab 60, Esaote, Genova, Italy, linear probe 6–18 MHz) was performed on hand joints, and a 10-joint US score was calculated for each patient.ResultsData on lymphocytes subsets were avaiable for 90 patients. The majority of patients were Caucasian women with a median disease duration of 6 years (interquartile range: 2–13 years). Mean DAS28 was 4.28 (SD ± 1.64) and mean HAQ score was 1.11 (SD ± 0.83).There was no significant correlation of 10-joint GS score (rS = 0.122, 95% CI: − 0.124 to 0.336, P = 0.254) and 10-joint pD score (rS = 0.056, 95% CI: − 0.180 to 0.273, P = 0.602) with the mean percentage of peripheral Treg cells. Also, 10-joint GS score (rS = 0.083, 95% CI: − 0.125 to 0.302, P = 0.438) and 10-joint pD score 10 (rS = − 0.060, 95% CI: − 0.271 to 0.150, P = 0.575); did not correlate to Th17 profile. No association of bone erosions on MSUS with Treg and Th17 profiles (P = 0.831 and P = 0.632, respectively) was observed.ConclusionIn this first study addressing MSUS features and lymphocytes subtypes in established RA, data did not support an association of circulating Tregs and Th17 lymphocytes with inflammatory and structural damage findings on MSUS.
Highlights
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by polyarthritis leading to synovial proliferation, pannus formation, bone erosions and joint deformities [1]
In this first study addressing muskuloskeletal ultrasound (MSUS) features and lymphocytes subtypes in established rheumatoid arthritis (RA), data did not support an association of circulating T regulatory (Treg) and Th17 lymphocytes with inflammatory and structural damage findings on MSUS
We evaluate the association of MSUS parameters with the T regulatory (Treg) and Th17 cell profiles
Summary
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by polyarthritis leading to synovial proliferation, pannus formation, bone erosions and joint deformities [1]. Besides the major role of cytokines in the development and progression of the disease, specially TNF-alpha and interleukins (IL) [2], regulatory T cells (Tregs) and lymphocytes producers of IL-17 (Th17) imbalance and disfuntion have been implicated in the pathogenesis of rheumatoid arthritis (RA) [3]. Synovial proliferation seen on gray scale ultrasound (GS) and synovial power Doppler (pD) signal are characteristics of joint inflammation. The association of plasma IL-6, a major inflammatory cytokine, with joint sonographic findings, specially power Doppler, was demonstrated in early RA [7] and established disease [8]. Gray scale synovial proliferation (GS), power Doppler signal (pD) and bone erosions seen on high resolution muskuloskeletal ultrasound (MSUS) are hallmarks of destructive articular disease
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