Synovial tissue features associated with poor prognosis in inflammatory arthritis
Abstract Background Inflammatory arthritis encompasses a group of immune-mediated diseases characterized by chronic joint inflammation. Despite having pathogenic mechanisms in common, the prognosis of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and undifferentiated arthritis (UA) could be...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13075-023-03255-9 |
| _version_ | 1797355578010370048 |
|---|---|
| author | Ana Belén Azuaga Andrea Cuervo Raquel Celis Beatriz Frade-Sosa Juan C. Sarmiento-Monroy Virginia Ruiz-Esquide José A. Gómez-Puerta Raimon Sanmartí Julio Ramírez |
| author_facet | Ana Belén Azuaga Andrea Cuervo Raquel Celis Beatriz Frade-Sosa Juan C. Sarmiento-Monroy Virginia Ruiz-Esquide José A. Gómez-Puerta Raimon Sanmartí Julio Ramírez |
| author_sort | Ana Belén Azuaga |
| collection | DOAJ |
| description | Abstract Background Inflammatory arthritis encompasses a group of immune-mediated diseases characterized by chronic joint inflammation. Despite having pathogenic mechanisms in common, the prognosis of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and undifferentiated arthritis (UA) could be different regarding progression to chronic, to erosive, or to self-limited disease. Our aim was to evaluate the potential association of synovial tissue (ST) inflammatory cell infiltrate, the presence of ectopic lymphoid neogenesis (LN +) structures, and poor prognosis factors (PPF) in patients with RA, PsA, and UA. Methods We conducted a retrospective study including patients with active arthritis (RA, PsA, UA) who had ST obtained by rheumatological arthroscopy or ultrasound-guided biopsy. Clinical, demographic, and immunohistochemical data of the synovium was evaluated. Patients with biological therapy at the time of synovial biopsy were excluded. PPF in patients with RA and UA were defined by the presence of anti-cyclic citrullinated peptide antibodies and/or rheumatoid factor, development of bone erosions, or requirement of biological therapy during the follow-up. PPF in patients with PsA were defined as the presence of high levels of acute-phase reactants (ESR/CRP), dactylitis or nail involvement at the time of biopsy, development of bone erosion, or requirement of biological therapy during the follow-up. Results A total of 88 patients were included: 26 RA, 33 PsA, and 29 UA. All patients were followed up for 5 years after the biopsy. Fourteen (53.84%) RA patients had PPF, and 17 (65.38%) had LN + . LN + was associated with PPF (p 0.038) and biologic therapy initiation (p 0.018). A total of 14 (43.75%) PsA patients had PPF. CD15 infiltrate (410.68 [SD 477.63] cells/mm2) was associated with PPF (p 0.008) in PsA patients. Sixteen (55.17%) patients with UA had PPF, and 13 (44.82%) had LN + . In this group, synovial CD68 + macrophages cells density was negatively correlated with DAS28-CRP (r = − 0.346, p 0.042). Conclusions The presence of LN + and higher CD15 + polymorphonuclear cells infiltrate was associated with PPF in RA and PsA, respectively. No associations were found for UA. These findings suggest a great heterogeneity of the ST features and its pathogenic implications in the subtypes of inflammatory arthritis. |
| first_indexed | 2024-03-08T14:14:09Z |
| format | Article |
| id | doaj.art-65f44a5fd44b4e708acc97ae275226ac |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-03-08T14:14:09Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-65f44a5fd44b4e708acc97ae275226ac2024-01-14T12:31:28ZengBMCArthritis Research & Therapy1478-63622024-01-012611810.1186/s13075-023-03255-9Synovial tissue features associated with poor prognosis in inflammatory arthritisAna Belén Azuaga0Andrea Cuervo1Raquel Celis2Beatriz Frade-Sosa3Juan C. Sarmiento-Monroy4Virginia Ruiz-Esquide5José A. Gómez-Puerta6Raimon Sanmartí7Julio Ramírez8Rheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital General de GranollersRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaRheumatology Department, Hospital Clinic of BarcelonaAbstract Background Inflammatory arthritis encompasses a group of immune-mediated diseases characterized by chronic joint inflammation. Despite having pathogenic mechanisms in common, the prognosis of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and undifferentiated arthritis (UA) could be different regarding progression to chronic, to erosive, or to self-limited disease. Our aim was to evaluate the potential association of synovial tissue (ST) inflammatory cell infiltrate, the presence of ectopic lymphoid neogenesis (LN +) structures, and poor prognosis factors (PPF) in patients with RA, PsA, and UA. Methods We conducted a retrospective study including patients with active arthritis (RA, PsA, UA) who had ST obtained by rheumatological arthroscopy or ultrasound-guided biopsy. Clinical, demographic, and immunohistochemical data of the synovium was evaluated. Patients with biological therapy at the time of synovial biopsy were excluded. PPF in patients with RA and UA were defined by the presence of anti-cyclic citrullinated peptide antibodies and/or rheumatoid factor, development of bone erosions, or requirement of biological therapy during the follow-up. PPF in patients with PsA were defined as the presence of high levels of acute-phase reactants (ESR/CRP), dactylitis or nail involvement at the time of biopsy, development of bone erosion, or requirement of biological therapy during the follow-up. Results A total of 88 patients were included: 26 RA, 33 PsA, and 29 UA. All patients were followed up for 5 years after the biopsy. Fourteen (53.84%) RA patients had PPF, and 17 (65.38%) had LN + . LN + was associated with PPF (p 0.038) and biologic therapy initiation (p 0.018). A total of 14 (43.75%) PsA patients had PPF. CD15 infiltrate (410.68 [SD 477.63] cells/mm2) was associated with PPF (p 0.008) in PsA patients. Sixteen (55.17%) patients with UA had PPF, and 13 (44.82%) had LN + . In this group, synovial CD68 + macrophages cells density was negatively correlated with DAS28-CRP (r = − 0.346, p 0.042). Conclusions The presence of LN + and higher CD15 + polymorphonuclear cells infiltrate was associated with PPF in RA and PsA, respectively. No associations were found for UA. These findings suggest a great heterogeneity of the ST features and its pathogenic implications in the subtypes of inflammatory arthritis.https://doi.org/10.1186/s13075-023-03255-9Synovial tissuePoor prognosis factorRheumatoid arthritisPsoriatic arthritisUndifferentiated arthritis |
| spellingShingle | Ana Belén Azuaga Andrea Cuervo Raquel Celis Beatriz Frade-Sosa Juan C. Sarmiento-Monroy Virginia Ruiz-Esquide José A. Gómez-Puerta Raimon Sanmartí Julio Ramírez Synovial tissue features associated with poor prognosis in inflammatory arthritis Arthritis Research & Therapy Synovial tissue Poor prognosis factor Rheumatoid arthritis Psoriatic arthritis Undifferentiated arthritis |
| title | Synovial tissue features associated with poor prognosis in inflammatory arthritis |
| title_full | Synovial tissue features associated with poor prognosis in inflammatory arthritis |
| title_fullStr | Synovial tissue features associated with poor prognosis in inflammatory arthritis |
| title_full_unstemmed | Synovial tissue features associated with poor prognosis in inflammatory arthritis |
| title_short | Synovial tissue features associated with poor prognosis in inflammatory arthritis |
| title_sort | synovial tissue features associated with poor prognosis in inflammatory arthritis |
| topic | Synovial tissue Poor prognosis factor Rheumatoid arthritis Psoriatic arthritis Undifferentiated arthritis |
| url | https://doi.org/10.1186/s13075-023-03255-9 |
| work_keys_str_mv | AT anabelenazuaga synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT andreacuervo synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT raquelcelis synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT beatrizfradesosa synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT juancsarmientomonroy synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT virginiaruizesquide synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT joseagomezpuerta synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT raimonsanmarti synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis AT julioramirez synovialtissuefeaturesassociatedwithpoorprognosisininflammatoryarthritis |