Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis

ObjectivesThis study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA).MethodsActive RA patients with a knee needle synovial biopsy at baseline and finished 1...

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Autores principales:	Xue-Pei Zhang, Jian-Da Ma, Ying-Qian Mo, Jun Jing, Dong-Hui Zheng, Le-Feng Chen, Tao Wu, Chu-Tao Chen, Qian Zhang, Yao-Yao Zou, Jian-Zi Lin, Yan-Hui Xu, Yao-Wei Zou, Ze-Hong Yang, Li Ling, Pierre Miossec, Lie Dai
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	rheumatoid arthritis synovial tissue myeloid-stromal pathotype stromal cells radiographic progression Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/a42c9d79150a45edaa193acd2e3558a1
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spelling	oai:doaj.org-article:a42c9d79150a45edaa193acd2e3558a12021-11-30T13:13:59ZAddition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis1664-322410.3389/fimmu.2021.778480https://doaj.org/article/a42c9d79150a45edaa193acd2e3558a12021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.778480/fullhttps://doaj.org/toc/1664-3224ObjectivesThis study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA).MethodsActive RA patients with a knee needle synovial biopsy at baseline and finished 1-year follow-up were recruited from a real-world prospective cohort. Positive staining for CD20, CD38, CD3, CD68, CD31, and CD90 were scored semiquantitatively (0-4). The primary outcome was radiographic progression defined as a minimum increase of 0.5 units of the modified total Sharp score from baseline to 1 year.ResultsAmong 150 recruited RA patients, 123 (82%) had qualified synovial tissue. Higher scores of CD20+ B cells, sublining CD68+ macrophages, CD31+ endothelial cells, and CD90+ fibroblasts were associated with less decrease in disease activity and greater increase in radiographic progression. A new fibroblast-based classification of synovial pathotypes giving more priority to myeloid and stromal cells classified samples as myeloid-stromal (57.7%, 71/123), lymphoid (31.7%, 39/123), and paucicellular pathotypes (10.6%, 13/123). RA patients with myeloid-stromal pathotype showed the highest rate of radiographic progression (43.7% vs. 23.1% vs. 7.7%, p = 0.011), together with the lowest rate of Boolean remission at 3, 6, and 12 months. Baseline synovial myeloid-stromal pathotype independently predicted radiographic progression at 1 year (adjusted OR: 3.199, 95% confidence interval (95% CI): 1.278, 8.010). Similar results were obtained in a subgroup analysis of treatment-naive RA.ConclusionsThis novel fibroblast-based myeloid-stromal pathotype could predict radiographic progression at 1 year in active RA patients which may contribute to the shift of therapeutic decision in RA.Xue-Pei ZhangJian-Da MaYing-Qian MoJun JingDong-Hui ZhengLe-Feng ChenTao WuChu-Tao ChenQian ZhangYao-Yao ZouJian-Zi LinYan-Hui XuYao-Wei ZouZe-Hong YangLi LingPierre MiossecLie DaiFrontiers Media S.A.articlerheumatoid arthritissynovial tissuemyeloid-stromal pathotypestromal cellsradiographic progressionImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis synovial tissue myeloid-stromal pathotype stromal cells radiographic progression Immunologic diseases. Allergy RC581-607
spellingShingle	rheumatoid arthritis synovial tissue myeloid-stromal pathotype stromal cells radiographic progression Immunologic diseases. Allergy RC581-607 Xue-Pei Zhang Jian-Da Ma Ying-Qian Mo Jun Jing Dong-Hui Zheng Le-Feng Chen Tao Wu Chu-Tao Chen Qian Zhang Yao-Yao Zou Jian-Zi Lin Yan-Hui Xu Yao-Wei Zou Ze-Hong Yang Li Ling Pierre Miossec Lie Dai Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
description	ObjectivesThis study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA).MethodsActive RA patients with a knee needle synovial biopsy at baseline and finished 1-year follow-up were recruited from a real-world prospective cohort. Positive staining for CD20, CD38, CD3, CD68, CD31, and CD90 were scored semiquantitatively (0-4). The primary outcome was radiographic progression defined as a minimum increase of 0.5 units of the modified total Sharp score from baseline to 1 year.ResultsAmong 150 recruited RA patients, 123 (82%) had qualified synovial tissue. Higher scores of CD20+ B cells, sublining CD68+ macrophages, CD31+ endothelial cells, and CD90+ fibroblasts were associated with less decrease in disease activity and greater increase in radiographic progression. A new fibroblast-based classification of synovial pathotypes giving more priority to myeloid and stromal cells classified samples as myeloid-stromal (57.7%, 71/123), lymphoid (31.7%, 39/123), and paucicellular pathotypes (10.6%, 13/123). RA patients with myeloid-stromal pathotype showed the highest rate of radiographic progression (43.7% vs. 23.1% vs. 7.7%, p = 0.011), together with the lowest rate of Boolean remission at 3, 6, and 12 months. Baseline synovial myeloid-stromal pathotype independently predicted radiographic progression at 1 year (adjusted OR: 3.199, 95% confidence interval (95% CI): 1.278, 8.010). Similar results were obtained in a subgroup analysis of treatment-naive RA.ConclusionsThis novel fibroblast-based myeloid-stromal pathotype could predict radiographic progression at 1 year in active RA patients which may contribute to the shift of therapeutic decision in RA.
format	article
author	Xue-Pei Zhang Jian-Da Ma Ying-Qian Mo Jun Jing Dong-Hui Zheng Le-Feng Chen Tao Wu Chu-Tao Chen Qian Zhang Yao-Yao Zou Jian-Zi Lin Yan-Hui Xu Yao-Wei Zou Ze-Hong Yang Li Ling Pierre Miossec Lie Dai
author_facet	Xue-Pei Zhang Jian-Da Ma Ying-Qian Mo Jun Jing Dong-Hui Zheng Le-Feng Chen Tao Wu Chu-Tao Chen Qian Zhang Yao-Yao Zou Jian-Zi Lin Yan-Hui Xu Yao-Wei Zou Ze-Hong Yang Li Ling Pierre Miossec Lie Dai
author_sort	Xue-Pei Zhang
title	Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
title_short	Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
title_full	Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
title_fullStr	Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
title_full_unstemmed	Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis
title_sort	addition of fibroblast-stromal cell markers to immune synovium pathotypes better predicts radiographic progression at 1 year in active rheumatoid arthritis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a42c9d79150a45edaa193acd2e3558a1
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Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis

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