Synovial features of patients with rheumatoid arthritis and psoriatic arthritis in clinical and ultrasound remission differ under anti-TNF therapy: a clue to interpret different chances of relapse after clinical remission?
Synovial features of patients with rheumatoid arthritis and psoriatic arthritis in clinical and ultrasound remission differ under anti-TNF therapy: a clue to interpret different chances of relapse after clinical remission?
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DOI：
10.1136/annrheumdis-2016-210424
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发表时间：
2017-07
影响因子：
27.4
通讯作者：
Gremese E
中科院分区：
文献类型：
--
作者：
Alivernini S;Tolusso B;Petricca L;Bui L;Di Sante G;Peluso G;Benvenuto R;Fedele AL;Federico F;Ferraccioli G;Gremese E
定义类风湿关节炎（RA）和银屑病关节炎（PsA）患者的滑膜特征，通过甲氨蝶呤（MTX）和肿瘤坏死因子（TNF）阻滞剂联合治疗达到临床和超声缓解。缓解期RA患者（n=25）（疾病活动性评分(DAS)<1.6，持续至少6个月）、低疾病活动性RA患者（n=10） （1.6<DAS<2.4，持续至少6个月）和PsA缓解期患者（n=18） （DAS<1.6，银屑病区域严重指数(PASI)=0，持续至少6个月）通过MTX+抗tnf（阿达木单抗40 mg或依那西普50 mg）联合动力多普勒（PDUS）阴性滑膜肥大患者行滑膜组织活检。高/中度RA患者naïve接受治疗（n=50）作为对照组。对cd68、CD21、CD20、CD3、CD31和胶原蛋白进行免疫染色。pdus阴性缓解期RA滑膜CD68+、CD20+、CD3+细胞、CD31+血管和胶原沉积组织学评分低于pdus阳性高/中度RA患者（衬层和亚衬层均p<0.05）。此外，在CD68+、CD20+、CD3+、CD31+细胞和胶原蛋白的衬里和衬里方面，与pdus阴性的RA缓解组和LDA组相比，差异均无统计学意义。相反，PsA缓解期的PsA阴性患者在CD68+ (p=0.02)和CD3+细胞（p=0.04）以及CD31+血管（p<0.001）方面的组织学评分高于缓解期的PsA阴性患者。pdus阴性缓解期RA患者的滑膜组织学特征与LDA期pdus阴性RA患者相似。然而，PsA缓解期患者的特点是滑膜残余炎症程度高于RA缓解期患者，尽管在TNF抑制下PDUS呈阴性。
To define the synovial characteristics of patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in clinical and ultrasound remission achieved by combination therapy with methotrexate (MTX) and tumour necrosis factor (TNF) blockers. Patients with RA in remission (n=25) (disease activity score (DAS)<1.6 for at least 6 months), patients with RA in low disease activity (LDA) (n=10) (1.6<DAS<2.4 for at least 6 months) and patients with PsA in remission (n=18) (DAS<1.6 and Psoriasis Area Severity Index (PASI)=0 for at least 6 months) achieved by MTX+anti-TNF (adalimumab 40 mg or etanercept 50 mg) with power Doppler (PDUS)-negative synovial hypertrophy underwent synovial tissue biopsy. Patients with RA with high/moderate disease naïve to treatment (n=50) were included as a comparison group. Immunostaining for cluster designation (CD)68, CD21, CD20, CD3, CD31 and collagen was performed. PDUS-negative patients with RA in remission showed lower histological scores for synovial CD68+, CD20+, CD3+ cells and CD31+ vessels and collagen deposition (p<0.05 for both lining and sublining) compared with PDUS-positive patients with RA with high/moderate disease. In addition, there was no significant difference in terms of lining and sublining CD68+, CD20+, CD3+, CD31+ cells and collagen comparing PDUS-negative patients with RA in remission and in LDA, respectively. On the contrary, PDUS-negative patients with PsA in remission showed higher histological scores for sublining CD68+ (p=0.02) and CD3+ cells (p=0.04) as well as CD31+ vessels (p<0.001) than PDUS-negative patients with RA in remission. PDUS-negative patients with RA in remission have comparable synovial histological features than PDUS-negative patients with RA in LDA. However, patients with PsA in remission are characterised by a higher degree of residual synovial inflammation than patients with RA in remission, despite PDUS negativity under TNF inhibition.
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影响因子：
4.9
作者：
Ramírez J;Ruíz-Esquide V;Pomés I;Celis R;Cuervo A;Hernández MV;Pomés J;Pablos JL;Sanmartí R;Cañete JD
通讯作者：
Cañete JD
影响因子：
27.4
作者：
van de Sande, Marleen G. H.;Gerlag, Danielle M.;Tak, Paul P.
通讯作者：
Tak, Paul P.
DOI：
10.1136/bmj.i4205
发表时间：
2016-08-16
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Haavardsholm EA;Aga AB;Olsen IC;Lillegraven S;Hammer HB;Uhlig T;Fremstad H;Madland TM;Lexberg ÅS;Haukeland H;Rødevand E;Høili C;Stray H;Noraas A;Hansen IJ;Bakland G;Nordberg LB;van der Heijde D;Kvien TK
通讯作者：
Kvien TK
影响因子：
27.4
作者：
Dougados, Maxime;Devauchelle-Pensec, Valerie;Szkudlarek, Marcin
通讯作者：
Szkudlarek, Marcin
影响因子：
1.1
作者：
Ozgocmen, Salih;Ozdemir, Huseyin;Ardicoglu, Ozge
通讯作者：
Ardicoglu, Ozge