Baseline Numbers of Circulating CD28-negative T Cells May Predict Clinical Response to Abatacept in Patients with Rheumatoid Arthritis
Baseline Numbers of Circulating CD28-negative T Cells May Predict Clinical Response to Abatacept in Patients with Rheumatoid Arthritis
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DOI：
10.3899/jrheum.110386
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发表时间：
2011-10-01
影响因子：
3.9
通讯作者：
Airo', Paolo
中科院分区：
文献类型：
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作者：
Scarsi, Mirko;Ziglioli, Tamara;Airo', Paolo
Objective.评估循环CD 28阴性（CD 28）T细胞数量作为类风湿关节炎（RA）患者对阿巴西普临床反应的预测因子。采用流式细胞术检测32例接受阿巴西普治疗的RA患者外周血CD 28 T细胞亚群。应用受试者-操作者曲线来检查T细胞群体的预测值，并选择最佳测试性能的截止值。根据C-反应蛋白的疾病活动性评分28定义缓解。阿巴西普治疗6个月后，CD 8 + CD 28-和CD 4 + CD 28-细胞对缓解的总体预测值分别为0.802（SE 0.078）和0.743（SE 0.089）。< 87 CD 8 + CD 28细胞/μ l和< 28 CD 4 + CD 28-细胞/μ l的临界值分别具有80.0%的敏感性和81.8%的特异性（Fisher检验：p = 0.001），以及60.0%的敏感性和77.3%的特异性（p = 0.043），用于预测6个月时的缓解。基线CD 8 + CD 28 T细胞数量低的患者在6个月内达到缓解的概率比这些细胞水平高的患者高4倍以上。一个简单的实验室测量，循环CD 28 T细胞的基线数量，预测RA患者阿巴西普治疗6个月后的缓解。（2011年8月1日首次发布; J Rheumol 2011;38：2105-11; doi：10.3899/jrheum.110386）
Objective. To evaluate the number of circulating CD28-negative (CD28) T cells as a predictor of clinical response to abatacept in patients with rheumatoid arthritis (RA).Methods. Peripheral blood CD28 T cell subsets were evaluated by flow cytometry at baseline in 32 patients with RA treated with abatacept. Receiver-operator curves were applied to examine the predictive value of T cell populations and to choose the cutoff for the best performance of the test. Remission was defined using the Disease Activity Score 28 based on C-reactive protein.Results. The overall predictive values of the CD8+CD28- and CD4+CD28- cells for remission after 6 months of abatacept therapy were 0.802 (SE 0.078) and 0.743 (SE 0.089), respectively. Cutoff values of < 87 CD8+CD28 cells/mu l and < 28 CD4+CD28- cells/mu l had 80.0% sensitivity and 81.8% specificity (Fisher test: p = 0.001), and 60.0% sensitivity and 77.3% specificity (p = 0.043), respectively, for prediction of remission at 6 months. Patients having low baseline numbers of CD8+CD28 T cells had a more than 4-fold higher probability of achieving remission within 6 months than patients with higher levels of these cells.Conclusion. A simple laboratory measure, the baseline number of circulating CD28 T cells, predicted remission after 6 months of abatacept treatment in patients with RA. (First Release Aug 1 2011; J Rheumatol 2011;38:2105-11; doi:10.3899/jrheum.110386)