Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis
Objective To investigate whether digital activity fluorescence optical imaging (FOI) patterns of inflammation can identify distinct rheumatoid arthritis (RA) phenotypes. Methods The hands of newly diagnosed patients with RA were evaluated by clinical examination, musculoskeletal ultrasound, and FOI....
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-09-01
|
| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11599 |
| _version_ | 1797684825212059648 |
|---|---|
| author | Yogan Kisten Laurent Arnaud Adrian Levitsky Noémi Györi Per Larsson Aase Hensvold Anca Catrina Erik af Klint Hamed Rezaei |
| author_facet | Yogan Kisten Laurent Arnaud Adrian Levitsky Noémi Györi Per Larsson Aase Hensvold Anca Catrina Erik af Klint Hamed Rezaei |
| author_sort | Yogan Kisten |
| collection | DOAJ |
| description | Objective To investigate whether digital activity fluorescence optical imaging (FOI) patterns of inflammation can identify distinct rheumatoid arthritis (RA) phenotypes. Methods The hands of newly diagnosed patients with RA were evaluated by clinical examination, musculoskeletal ultrasound, and FOI. Inflammation on FOI was defined when capillary leakage and/or fluorophore perfusion was present. The FOI composite image was quantified into a digital disease activity (DACT) score, using novel computerized algorithms. Unsupervised clustering on FOI inflammatory patterns was used to identify subgroups of patients relative to anticyclic citrullinated peptides (ACPA) and/or rheumatoid factor (RF). Results Of 1326 examined hand joints in 39 patients with RA (72% female; 56% ever‐smokers; 54% RF positive and 69% ACPA positive), 400 (30%) showed inflammation by FOI, and 95% (37 of 39) of patients had DACT‐FOI scores greater than 1. Unsupervised analysis on FOI patterns revealed two patient clusters, cluster 1 (n = 29) and cluster 2 (n = 10). The proportion of seropositive patients was significantly higher in cluster 1 versus cluster 2 (90%, 26 of 29 vs. 30%, 3 of 10; P < 0.01), whereas C‐reactive‐protein levels (minimum‐maximum) were significantly higher in cluster 2 (20 mg/l [1‐102]) versus cluster 1 (2 mg/l [0‐119]; P = 0.01). A wider variety and proportion of inflamed joints emerged for patients with RA in cluster 2 versus cluster 1, in which inflammation was more concentrated around the wrists and the right metacarpophalangeal 2 (MCP2), bilateral MCP3, and, to a lesser degree, left MCP2 and proximal interphalangeal joint and tendon regions. Cluster 1 displayed lower mean (±SD) DACT scores compared with cluster 2 (3.6 ± 2.1 vs. 5.4 ± 2.1; P = 0.03). Conclusion FOI‐based digital quantification of hand joint inflammation revealed two distinct RA subpopulations with and without ACPA and RF related autoantibodies. |
| first_indexed | 2024-03-12T00:36:20Z |
| format | Article |
| id | doaj.art-9c4bcc59d748443eb8094a9afe40ce8d |
| institution | Directory Open Access Journal |
| issn | 2578-5745 |
| language | English |
| last_indexed | 2024-03-12T00:36:20Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj.art-9c4bcc59d748443eb8094a9afe40ce8d2023-09-15T09:36:43ZengWileyACR Open Rheumatology2578-57452023-09-015947448010.1002/acr2.11599Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid ArthritisYogan Kisten0Laurent Arnaud1Adrian Levitsky2Noémi Györi3Per Larsson4Aase Hensvold5Anca Catrina6Erik af Klint7Hamed Rezaei8Karolinska Institute and Karolinska University Hospital Stockholm SwedenHôpitaux Universitaires de Strasbourg Service de Rhumatologie National Reference Center for Rare Systemic Autoimmune Diseases Strasbourg Alsace‐Champagne‐Ardenne FranceKarolinska Institute and Karolinska University Hospital Stockholm SwedenKarolinska Institute and Karolinska University Hospital Stockholm SwedenAcademic Specialist Center Stockholm SwedenKarolinska Institute and Karolinska University Hospital and Academic Specialist Center Stockholm SwedenKarolinska Institute and Karolinska University Hospital and Academic Specialist Center Stockholm SwedenKarolinska Institute and Karolinska University Hospital Stockholm SwedenKarolinska Institute and Karolinska University Hospital Stockholm SwedenObjective To investigate whether digital activity fluorescence optical imaging (FOI) patterns of inflammation can identify distinct rheumatoid arthritis (RA) phenotypes. Methods The hands of newly diagnosed patients with RA were evaluated by clinical examination, musculoskeletal ultrasound, and FOI. Inflammation on FOI was defined when capillary leakage and/or fluorophore perfusion was present. The FOI composite image was quantified into a digital disease activity (DACT) score, using novel computerized algorithms. Unsupervised clustering on FOI inflammatory patterns was used to identify subgroups of patients relative to anticyclic citrullinated peptides (ACPA) and/or rheumatoid factor (RF). Results Of 1326 examined hand joints in 39 patients with RA (72% female; 56% ever‐smokers; 54% RF positive and 69% ACPA positive), 400 (30%) showed inflammation by FOI, and 95% (37 of 39) of patients had DACT‐FOI scores greater than 1. Unsupervised analysis on FOI patterns revealed two patient clusters, cluster 1 (n = 29) and cluster 2 (n = 10). The proportion of seropositive patients was significantly higher in cluster 1 versus cluster 2 (90%, 26 of 29 vs. 30%, 3 of 10; P < 0.01), whereas C‐reactive‐protein levels (minimum‐maximum) were significantly higher in cluster 2 (20 mg/l [1‐102]) versus cluster 1 (2 mg/l [0‐119]; P = 0.01). A wider variety and proportion of inflamed joints emerged for patients with RA in cluster 2 versus cluster 1, in which inflammation was more concentrated around the wrists and the right metacarpophalangeal 2 (MCP2), bilateral MCP3, and, to a lesser degree, left MCP2 and proximal interphalangeal joint and tendon regions. Cluster 1 displayed lower mean (±SD) DACT scores compared with cluster 2 (3.6 ± 2.1 vs. 5.4 ± 2.1; P = 0.03). Conclusion FOI‐based digital quantification of hand joint inflammation revealed two distinct RA subpopulations with and without ACPA and RF related autoantibodies.https://doi.org/10.1002/acr2.11599 |
| spellingShingle | Yogan Kisten Laurent Arnaud Adrian Levitsky Noémi Györi Per Larsson Aase Hensvold Anca Catrina Erik af Klint Hamed Rezaei Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis ACR Open Rheumatology |
| title | Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis |
| title_full | Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis |
| title_fullStr | Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis |
| title_full_unstemmed | Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis |
| title_short | Distinct Fluorescence Optical Imaging Patient Clusters Emerge for Seropositive and Seronegative Rheumatoid Arthritis |
| title_sort | distinct fluorescence optical imaging patient clusters emerge for seropositive and seronegative rheumatoid arthritis |
| url | https://doi.org/10.1002/acr2.11599 |
| work_keys_str_mv | AT yogankisten distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT laurentarnaud distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT adrianlevitsky distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT noemigyori distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT perlarsson distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT aasehensvold distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT ancacatrina distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT erikafklint distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis AT hamedrezaei distinctfluorescenceopticalimagingpatientclustersemergeforseropositiveandseronegativerheumatoidarthritis |