Disease activity drives transcriptomic heterogeneity in early untreated rheumatoid synovitis

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..

OBJECTIVES: Transcriptomic profiling of synovial tissue from patients with early, untreated rheumatoid arthritis (RA) was used to explore the ability of unbiased, data-driven approaches to define clinically relevant subgroups.

METHODS: RNASeq was performed on 74 samples, with disease activity data collected at inclusion. Principal components analysis (PCA) and unsupervised clustering were used to define patient clusters based on expression of the most variable genes, followed by pathway analysis and inference of relative abundance of immune cell subsets. Histological assessment and multiplex immunofluorescence (for CD45, CD68, CD206) were performed on paraffin sections.

RESULTS: PCA on expression of the (n=894) most variable genes across this series did not divide samples into distinct groups, instead yielding a continuum correlated with baseline disease activity. Two patient clusters (PtC1, n=52; PtC2, n=22) were defined based on expression of these genes. PtC1, with significantly higher disease activity and probability of response to methotrexate therapy, showed upregulation of immune system genes; PtC2 showed upregulation of lipid metabolism genes, described to characterise tissue resident or M2-like macrophages. In keeping with these data, M2-like:M1-like macrophage ratios were inversely correlated with disease activity scores and were associated with lower synovial immune infiltration and the presence of thinner, M2-like macrophage-rich synovial lining layers.

CONCLUSION: In this large series of early, untreated RA, we show that the synovial transcriptome closely mirrors clinical disease activity and correlates with synovial inflammation. Intriguingly, lower inflammation and disease activity are associated with higher ratios of M2:M1 macrophages, particularly striking in the synovial lining layer. This may point to a protective role for tissue resident macrophages in RA.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:82

Enthalten in:

Annals of the rheumatic diseases - 82(2023), 12 vom: 28. Dez., Seite 1538-1546

Sprache:

Englisch

Beteiligte Personen:

Triaille, Clément [VerfasserIn]
Tilman, Gaëlle [VerfasserIn]
Sokolova, Tatiana [VerfasserIn]
Loriot, Axelle [VerfasserIn]
Marchandise, Joelle [VerfasserIn]
De Montjoye, Stéphanie [VerfasserIn]
Nzeusseu-Toukap, Adrien [VerfasserIn]
Méric de Bellefon, Laurent [VerfasserIn]
Bouzin, Caroline [VerfasserIn]
Galant, Christine [VerfasserIn]
Durez, Patrick [VerfasserIn]
Lauwerys, Bernard R [VerfasserIn]
Limaye, Nisha [VerfasserIn]

Links:

Volltext

Themen:

Arthritis, rheumatoid
Journal Article
Methotrexate
Research Support, Non-U.S. Gov't
Synovitis

Anmerkungen:

Date Completed 13.11.2023

Date Revised 19.11.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1136/ard-2023-224068

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360070787