Synovium CD20 expression is a potential new predictor of bone erosion progression in very-early arthritis treated by sequential DMARDs monotherapy - A pilot study from the VErA cohort
Synovium CD20 expression is a potential new predictor of bone erosion progression in very-early arthritis treated by sequential DMARDs monotherapy - A pilot study from the VErA cohort
复制标题
DOI：
10.1016/j.jbspin.2011.11.006
复制
发表时间：
2012-12-01
期刊：
影响因子：
4.2
通讯作者：
Vittecoq, Olivier
中科院分区：
文献类型：
--
作者：
Lanfant-Weybel, Karine;Michot, Chantal;Vittecoq, Olivier
目的：因为现有的生物标志物（类风湿因子[RF]、抗环瓜氨酸自身抗体[抗CCP 2]、第1小时红细胞沉降率[ESR]/C反应肽[CRP]和骨侵蚀）不足以预测类风湿关节炎（RA）结构损伤，以确定大于或等于1个标志物的滑膜表达是否可以构成新的预后因子。该研究在18例前瞻性入组的未接受过疾病缓解抗风湿药物（DMARD）和糖皮质激素治疗的极早期关节炎VErA队列患者中进行（中位持续时间：4个月）。基线时记录的有：临床和生物学（血清ESR、CRP、RF同种型、抗CCP 2、骨保护素、核κ B受体激活剂配体[RANK-L]和软骨寡聚基质蛋白[COMP]水平）数据;掌指关节滑膜活检的滑膜表达（HLA-DR、CD 163、CD 3、CD 20、VEGF、骨保护素、RANKL、Bcl 2和整体炎症指数）。采用货车der Heijde改良的Sharp评分对基线和3年手足X线片进行分级;判断标准是随访期间的进展。Pearson的产品矩相关统计被用来测试配对samples.Results之间的关联：基线，一个显着的关系，发现之间的侵蚀性损伤和B细胞活化的标志物，特别是滑膜CD 20的表达（r = 0.68，P = 0.0001）。通过改良Sharp糜烂评分变异进行量化，3年结构损伤进展与以下因素显著相关：（r = 0.75; P = 0.0003），-IgM（r = 0.69; P = 0.001），抗CCP 2（r = 0.53; P = 0.02）和RANK-L（r = 0.61; P = 0.007）;滑膜CD 20表达（r = 0.70; P = 0.001）。本研究在有限的前瞻性随访样本中分析了大量滑膜标志物的预后价值，证据充分的患者提示，滑膜CD 20和血清RANK-L水平可能是极早期RA结构损伤进展的新预测因子。(C)2011年法国rhumatologie协会。由Elsevier Masson SAS出版。All rights reserved.
Objective: Because available biomarkers (rheumatoid factors [RF], anti-cyclic citrullinated autoantibodies [anti-CCP2], erythrocyte sedimentation rate at 1st hour [ESR]/C-reactive peptide [CRP] and bone erosions) are insufficient to predict rheumatoid arthritis (RA) structural damage, to determine whether synovium expression of greater or equal to 1 markers could constitute new prognostic factor(s).Method: The study was conducted on 18 prospectively enrolled disease-modifying anti-rheumatic drug (DMARD)- and glucocorticoid-naive, VErA cohort patients with very-early arthritis (median duration: 4 months). Recorded at baseline were: clinical and biological (serum ESR, CRP, RF-isotypes, anti-CCP2, osteoprotegerin, receptor activator of nuclear kappa B-ligand [RANK-L] and cartilage oligomeric matrix protein [COMP] levels) data; synovium expression (HLA-DR, CD163, CD3, CD20, VEGF, osteoprotegerin, RANKL, Bcl2 and global inflammation index) for a metacarpophalangeal joint-synovium biopsy. Baseline and 3-year hand-and-foot X-rays were graded with the van der Heijde-modified-Sharp score; the judgment criterion was its progression during follow-up. Pearson's product moment correlation statistics were used to test for association between paired samples.Results: A baseline, a significant relationship was found between erosive damage and markers of B-cell activation, notably the synovium CD20 expression (r = 0.68; P = 0.0001). Quantified by the modified-Sharp erosion score variation, the 3-year structural damage progression was significantly correlated with: serum levels of RF-IgG (r = 0.75; P = 0.0003), -IgM (r = 0.69; P = 0.001), anti-CCP2 (r = 0.53; P = 0.02) and RANK-L (r = 0.61; P = 0.007); synovium CD20 expression (r = 0.70; P = 0.001).Conclusion: This analysis of the prognostic value of a large panel of synovium markers in a limited sample of prospectively followed, well-documented patients suggested that both synovial CD20 and serum RANK-L levels might be new predictors of structural damage progression in very-early RA. (C) 2011 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.