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Reduced thymic output, shorter telomeres seen in young patients with axial spondyloarthritis
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Younger patients with axial spondyloarthritis showed a reduction in thymic output and a premature senescence of T cells, according to data from a prospective, cross-sectional study.
Researchers studied 51 patients with axial spondyloarthritis (axSpA) who met the Assessment in Spondyloarthritis International Society classification criteria, 51 patients with rheumatoid arthritis (RA) who met the 2010 American College of Rheumatology/European League Against Rheumatism criteria and 50 healthy control participants.
Full medical history and demographics were collected, and blood samples were tested for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.
Patients with axSpA were assessed using the Bath Ankylosing Spondylitis Disease Activity Index, the Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Metrology Index, and 29.4% were found to have active disease. Among these patients, 33.3% had a disease duration of 2 years or fewer.
Patients with RA were assessed using the simplified disease activity index (SDAI) and the Disease Activity Score 28. Of the 43 patients who had SDAI values available for review, the researchers found 20.9% had high disease activity, 32.6% had moderate disease activity, 27.9% had low disease activity and 18.6% were in remission.
Clinical examination was performed to record the number of tender and swollen joints. Patients’ global assessment of disease activity, patients’ pain assessment and evaluators’ global assessment were determined on visual analogue scales.
Flow cytometry was performed on peripheral blood mononuclear cells to obtain CD4+ and CD8+ T cells. In a second step, CD45RA+ and CD45RO+ T cells were obtained via positive selection.
Statistical analysis was performed, with variables adjusted for differences by group, and regression analysis was performed to adjust for age and other possible confounders.
Thymus function between participant groups was determined by measuring T-cell receptor excision circles (TRECs) formed during T-cell receptor rearrangement in the thymus.
Multivariate regression analysis confirmed a significant, premature decline in TRECs in CD4+CD45RA T cells among patients younger than 45 years old with axSpA compared with healthy participants. Multivariate regression also confirmed the presence of shortened telomeres between patients with axSpA and healthy participants and additional positive correlation with younger age, according to the researchers.
Contrastingly, the researchers found that data for patients with RA were comparable to those observed in the healthy control group. – by Shirley Pulawski
Disclosures: The researchers report no relevant financial disclosures.
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