dc.contributor.author | Rivellese, F | en_US |
dc.contributor.author | Humby, F | en_US |
dc.contributor.author | Bugatti, S | en_US |
dc.contributor.author | Fossati-Jimack, L | en_US |
dc.contributor.author | Rizvi, H | en_US |
dc.contributor.author | Lucchesi, D | en_US |
dc.contributor.author | Lliso-Ribera, G | en_US |
dc.contributor.author | Nerviani, A | en_US |
dc.contributor.author | Hands, RE | en_US |
dc.contributor.author | Giorli, G | en_US |
dc.contributor.author | Frias, B | en_US |
dc.contributor.author | Thorborn, G | en_US |
dc.contributor.author | Jaworska, E | en_US |
dc.contributor.author | John, C | en_US |
dc.contributor.author | Goldmann, K | en_US |
dc.contributor.author | Lewis, MJ | en_US |
dc.contributor.author | Manzo, A | en_US |
dc.contributor.author | Bombardieri, M | en_US |
dc.contributor.author | Pitzalis, C | en_US |
dc.contributor.author | PEAC-R4RA Investigators | en_US |
dc.date.accessioned | 2020-03-20T12:47:00Z | |
dc.date.available | 2019-11-26 | en_US |
dc.date.issued | 2019-11-29 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/63258 | |
dc.description.abstract | OBJECTIVE: To define the relationship of synovial B cells to clinical phenotypes at different stages of disease evolution and drug exposure in rheumatoid arthritis (RA). METHODS: Synovial biopsy specimens and demographic and clinical data were collected from 2 RA cohorts (n = 329), one of patients with untreated early RA (n = 165) and one of patients with established RA with an inadequate response to tumor necrosis factor inhibitors (TNFi-IR; n = 164). Synovial tissue was subjected to hematoxylin and eosin and immunohistochemical staining and semiquantitative assessment for the degree of synovitis (on a scale of 0-9) and of CD20+ B cell infiltrate (on a scale of 0-4). B cell scores were validated by digital image analysis and B cell lineage-specific transcript analysis (RNA-Seq) in the early RA (n = 91) and TNFi-IR (n = 127) cohorts. Semiquantitative CD20 scores were used to classify patients as B cell rich (≥2) or B cell poor (<2). RESULTS: Semiquantitative B cell scores correlated with digital image analysis quantitative measurements and B cell lineage-specific transcripts. B cell-rich synovitis was present in 35% of patients in the early RA cohort and 47.7% of patients in the TNFi-IR cohort (P = 0.025). B cell-rich patients showed higher levels of disease activity and seropositivity for rheumatoid factor and anti-citrullinated protein antibody in early RA but not in established RA, while significantly higher histologic synovitis scores in B cell-rich patients were demonstrated in both cohorts. CONCLUSION: We describe a robust semiquantitative histologic B cell score that closely replicates the quantification of B cells by digital or molecular analyses. Our findings indicate an ongoing B cell-rich synovitis, which does not seem to be captured by standard clinimetric assessment, in a larger proportion of patients with established RA than early RA. | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Arthritis Rheumatol | en_US |
dc.rights | Creative Commons Attribution License | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.title | B Cell Synovitis and Clinical Phenotypes in Rheumatoid Arthritis: Relationship to Disease Stages and Drug Exposure. | en_US |
dc.type | Article | |
dc.rights.holder | © 2019 The Authors. | |
dc.identifier.doi | 10.1002/art.41184 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/31785084 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
dcterms.dateAccepted | 2019-11-26 | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | Synovial B cells inform treatment response in RA (SyBRA)::National Institute of Health Research (NIHR) | en_US |