Flow cytometry, immunophenotyping may improve management of patients with RA-ILD
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PHILADELPHIA — Significant and distinct shifts in critical “cellular players” were seen among patients with rheumatoid arthritis-associated interstitial lung disease, according to an ongoing study presented at ACR Convergence 2022.
“We know that monocytic and granulocytic myeloid derived suppressor cells may impact disease, as well as alternately activated monocytes,” Jill Poole, MD, professor of medicine and division chief in the division of allergy at the University of Nebraska Medical Center, said during the presentation.
Peripheral blood was collected from 15 patients with RA, 13 with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and 15 controls who did not have an autoimmune, lung or systemic inflammatory disease. Staining, processing and analysis of samples all occurred on the same day as collection, according to the presentation.
Across the three groups, the total frequency of peripheral blood monocyte did not differ across groups. However, the researchers observed a significantly higher frequency of intermediate monocytes among patients with RA and RA-ILD compared with controls. Patients with RA-ILD had the highest frequency intermediate monocytes.
When analyzing classical monocytes, patients with RA-ILD had significantly lower levels when compared with patients with RA and controls.
According to the poster, the rate of eosinophils was significantly higher in patients RA-ILD compared with controls, and polymorphonuclear myeloid derived suppressor cells (PMN-MDSCs) significantly increased in RA-ILD compared with controls despite no observed difference in PMNs across groups.
Moreover, the frequency of monocytic MDSCs was significantly higher in patients with RA-ILD compared with both patients with RA and controls. Finally, a “striking” shift towards high monocytic MDSCs compared with monocytes among patients with RA-ILD was observed, according to the poster.
“In general, these shifts in the RA-ILD subjects were more distinct than in just RA alone,” Poole said.
The preliminary results highlight increases in intermediate or non-classical monocytes and monocytic-MDSCs, as well as increases in PMN-MDSCs and eosinophils in patients with RA-ILD.
“Our conclusion is that flow cytometry myeloid cell immunophenotyping in patients with RA-ILD may provide comprehensive information on immune cell networks that could provide for a better understanding of disease pathogenesis and more effective management,” Poole said.
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Poole J, et al. Abstract 0249. Presented at: ACR Convergence 2022; November 11-14, 2022; Philadelphia (hybrid meeting).
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