December 2023 to March 2024
Author: Emre Bilgin & Rudi Shukla
Spring 2024 Press Review – RMD Open
Hughes et al (doi: 10.1136/rmdopen-2023-003328) examined synovial fluid using flow cytometry to identify which immune pathways are active in early inflammatory arthritis. Individuals with a final diagnosis of peripheral spondyloarthritis had a significantly enriched synovial IL-17A+CD8+ T (Tc17) cells compared to those diagnosed with seronegative undifferentiated inflammatory arthritis (p = 0.0054) or seropositive rheumatoid arthritis. This suggests that adaptive T cell pathways, particularly Tc17 in undifferentiated peripheral spondyloarthritis are active.
Coletto et al (doi: 10.1136/rmdopen-2023-003705) reported on results from the first intensive training programme to teach rheumatologists/residents to perform ultrasound-guided minimally invasive synovial tissue biopsy on knees and wrists of rheumatoid arthritis patients. They highlight that, with training, samples acquired by trainees was comparable with that of trainers (up to 92% of gradable synovial tissue acquired) with no negative impact on patient tolerability.
Brown et al (doi: 10.1136/rmdopen-2023-003858) explored the metabolic pathways involved in methotrexate mechanism of action within circulating CD4+T cells in a cohort of treatment naive patients with early rheumatoid arthritis. Using clinical data, flow-cytometry and transcriptional analysis they demonstrate that expression of elements of adenosine activity such as ectonucleotidase CD39, AMPD1, ADORA2b and ADORA3 are upregulated before treatment in those who respond to methotrexate.
Wang et al (doi: 10.1136/rmdopen-2023-003503) compared proportions of systemic lupus erythematosus patients with an indeterminate interferon- γ release test compared to other rheumatic musculoskeletal diseases and performed immunophenotyping and functional assays. They highlight the programmed death receptor 1 (PD-1)/programmed death-ligand 1 signalling pathway between exhausted CD8+ T cells and active memory B cells causes indeterminate interferon- γrelease test in systemic lupus erythematosus.
Tomelleri & Dejaco (doi: 10.1136/rmdopen-2023-003397) provided a viewpoint on emerging blood biomarkers such as IL-23, B-cell activating factor, osteopontin and calprotectin; and imaging strategies including ultrasound and 18FDG-PET/CT for disease stratification and monitoring of giant cell arteritis.
Emre Bilgin
Emre is a rheumatologist at Hacettepe University where he is doing his MSc on epidemiology. His main interests are rheumatoid arthritis, adult Still’s disease and ANCA-associated vasculitis, aside from his enthusiasm for editorial activities. Emre is a member of the Social Media Sub-Committee.
Rudi Shukla
Rudi Shukla is a clinical research fellow at the Centre for Musculoskeletal Research, University of Manchester, UK and a rheumatology trainee at Health Education England North West, UK. His research interests include outcome measures in inflammatory arthritis, musculoskeletal ultrasound and omics analyses. Rudi is a member of the Social Media Sub-Committee.