Remission Induced by TNF Inhibitors Plus Methotrexate is Associated With Changes in Peripheral Naïve B Cells in Patients With Rheumatoid Arthritis

Frontiers in Medicine

article

Borja Hernández-Breijo¹  Teresa Jurado¹  Paloma Lapuente-Suanzes²  Gema Bonilla³  Cristina Pijoán-Moratalla²  Garbiñe Roy²  Mónica Vázquez-Díaz²  Alejandro Balsa¹  Luisa M. Villar²  Dora Pascual-Salcedo¹  Eulalia Rodríguez-Martín²  Chamaida Plasencia-Rodríguez¹  Victoria Navarro-Compán¹  Carlota García-Hoz²  Israel Nieto-Gañán²  Cristina Sobrino²  Javier Bachiller-Corral²  Mariana Díaz-Almirón⁴  Ana Martínez-Feito¹ 

[1] Immuno-Rheumatology Research Group, Hospital La Paz Institute for Health Research-IdiPAZ;Ramón y Cajal Institute for Health Research, Hospital Universitario Ramón y Cajal;La Paz University Hospital;Biostatistics Unit, Hospital La Paz Institute for Health Research-IdiPAZ

关键词: rheumatoid arthritis;    autoimmunity;    B cells;    remission;    TNF inhibitors;   

DOI  :  10.3389/fmed.2021.683990

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Biological therapies, such as TNF inhibitors (TNFi), are increasing remission (REM) rates in rheumatoid arthritis (RA) patients, although these are still limited. The aim of our study was to analyze changes in the profile of peripheral blood mononuclear cells (PBMC) in patients with RA treated with TNFi in relation to the clinical response. This is a prospective and observational study including 78 RA patients starting the first TNFi. PBMC were analyzed by flow cytometry both at baseline and at 6 months. Disease activity at the same time points was assessed by DAS28, establishing DAS28 ≤ 2.6 as the criteria for REM. Logistic regression models were employed to analyze the association between the changes in PBMC and REM. After 6 months of TNFi treatment, 37% patients achieved REM by DAS28. Patients who achieved REM showed a reduction in the percentage of naive B cells, but only when patients had received concomitant methotrexate (MTX) (OR: 0.59; 95% CI: 0.39–0.91). However, no association was found for patients who did not receive concomitant MTX (OR: 0.85; 95% CI: 0.63–1.16). In conclusion, PBMC, mainly the B-cell subsets, are modified in RA patients with TNFi who achieve clinical REM. A significant decrease in naive B-cell percentage is associated with achieving REM after 6 months of TNFi treatment in patients who received concomitant therapy with MTX.

【 授权许可】

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