[Immunological characteristics of patients with anti-synthetase syndrome overlap with rheumatoid arthritis].

Q3 Medicine

北京大学学报（医学版） Pub Date : 2024-12-18

Liang Zhao, Chenglong Shi, Ke Ma, Jing Zhao, Xiao Wang, Xiaoyan Xing, Wanxing Mo, Yirui Lian, Chao Gao, Yuhui Li

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引用次数: 0

Abstract

Objective: To investigate the clinical and immunological characteristics of anti-synthetase syndrome (ASS) patients overlap with rheumatoid arthritis (RA).

Methods: A retrospective analysis was conducted on ASS patients with arthritis who were treated at Peking University People' s Hospital. Data collected included demographic information, clinical manifestations, laboratory features, lymphocyte subsets in peripheral blood, and treatments. The patients with ASS were divided into two groups based on the presence or absence of RA for comparative analysis.

Results: A total of 104 ASS patients with arthritis were included, among whom 23.1% (24/104) were diagnosed with RA. The ASS with RA group had a significantly higher incidence of rapidly progressive interstitial lung disease (RP-ILD) (41.7% vs. 17.6%, P=0.032), number of tender joints [10 (7, 14) vs. 4 (0, 8), P < 0.001], number of swollen joints [4 (2, 8) vs. 2 (0, 4), P=0.012], and rate of bone erosion (47.8% vs. 2.5%, P < 0.001) compared with the non-RA group. Levels of platelets [(289.57±68.74)×10³/μL vs. (247.94±77.04)×10³/μL, P=0.022], erythrocyte sedimentation rate (ESR) [43 (19, 59) mm/h vs. 18 (10, 44) mm/h, P=0.019], and C-reactive protein (CRP) [19.20 (4.80, 55.36) mg/L vs. 5.68 (1.10, 14.96) mg/L, P=0.006] were found significantly higher in the ASS with RA group than those in non-RA group. Analysis of immune cells in peripheral blood mononuclear cell (PBMC) showed that significantly decreased proportions of CLA⁺ Treg cells [(11.12±4.10)% vs. (17.22±8.49)%, P=0.003], B cells [8.56% (4.80%, 11.90%) vs. 14.55% (8.75%, 20.29%), P=0.025], and natural killer (NK) cells [7.56% (4.65%, 13.20%) vs. 13.25% (7.46%, 19.25%), P=0.045] in the overlap group compared with non-RA group. Proportion of Naïve Th cells [(52.66±17.66)% vs. (40.76±14.96)%, P=0.033)] was significantly increased in overlap group compared with non-RA group. Overlap group had lower rate of complete clinical response than non-RA group (16.7% vs. 43.8%, P=0.031).

Conclusion: Among ASS patients with arthritis, those with RA have more severe lung and joint involvement and a lower treatment response rate, highlighting the need for early recognition and aggressive intervention.

本刊更多论文

[抗合成酶综合征与类风湿性关节炎重叠患者的免疫学特征]。

目的：探讨抗合成酶综合征（ASS）合并类风湿关节炎（RA）患者的临床及免疫学特点。方法：对在北京大学人民医院治疗的ASS合并关节炎患者进行回顾性分析。收集的数据包括人口统计信息、临床表现、实验室特征、外周血淋巴细胞亚群和治疗。根据有无类风湿关节炎分为两组进行比较分析。结果：共纳入伴有关节炎的ASS患者104例，其中23.1%（24/104）诊断为RA。与非RA组相比，ASS合并RA组的快速进展性间质性肺疾病（RP-ILD）发生率（41.7% vs. 17.6%， P=0.032）、压痛关节数[10 (7,14)vs. 4 (0,8), P < 0.001]、肿胀关节数[4 (2,8)vs. 2 (0,4)， P=0.012]、骨侵蚀率（47.8% vs. 2.5%, P < 0.001）均显著高于RA组。合并RA组血小板水平[（289.57±68.74）×103/μL vs（247.94±77.04）×103/μL， P=0.022]、红细胞沉降率（ESR） [43 (19,59) mm/h vs. 18 (10,44) mm/h， P=0.019]、c反应蛋白（CRP） [19.20 (4.80, 55.36) mg/L vs. 5.68 (1.10, 14.96) mg/L， P=0.006]显著高于非RA组。外周血单核细胞（PBMC）免疫细胞分析显示，与非ra组相比，重叠组CLA+ Treg细胞(（11.12±4.10)%比（17.22±8.49）%，P=0.003）、B细胞（8.56%（4.80%,11.90%）比14.55% (8.75%,20.29%)，P=0.025）和自然杀伤细胞（NK）细胞（7.56%（4.65%,13.20%）比13.25% (7.46%,19.25%)，P=0.045）的比例显著降低。与非ra组相比，重叠组Naïve Th细胞比例[(52.66±17.66)% vs(40.76±14.96)%，P=0.033]显著升高。重叠组临床完全缓解率低于非ra组（16.7%比43.8%，P=0.031）。结论：在ASS合并关节炎患者中，RA患者肺部和关节受累更严重，治疗反应率更低，需要早期识别和积极干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

北京大学学报（医学版） Medicine-Medicine (all)

CiteScore

0.80

自引率

0.00%

发文量

9815

期刊介绍： Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.