Scandinavian Journal of Rheumatology最新文献

Objective: To investigate the function of mitophagy in instructing T-cell differentiation of patients with rheumatoid arthritis (RA).

Method: The mRNA and protein levels of optic atrophy protein-1 were detected in T cells from 94 RA patients and 37 age- and sex-matched healthy individuals by quantitative polymerase chain reaction and Western blotting. The impact of mitophagy on the differentiation of T cells was determined by flow cytometry. The therapeutic effect of targeting mitophagy was explored in humanized RA chimeras.

Results: Our study showed that T cells exerted high levels of mitophagy in RA patients. Since multiple T-cell subtypes play crucial roles in RA, we determined that mitophagy had a significant impact on the differentiation of tissue-resident memory T (Trm) cells, but not Th1 or Th17 cells. Importantly, we demonstrated that inhibiting mitophagy significantly reduced the number of Trm cells and downregulated inflammatory responses, as evidenced by diminished levels of T cell receptor β, interferon-γ, and interleukin-17A, in the humanized RA chimeras.

Conclusions: Mitophagy is elevated in RA T cells, leading to maldifferentiation of Trm cells in RA patients. Since these findings were obtained from clinical patients, mitophagy may be a potential therapeutic target for RA treatment.

Objective: To assess the agreement between child- and parent-reported orofacial symptoms in the Danish version of the patient questionnaire Assessment of Orofacial Symptoms in Juvenile Idiopathic Arthritis.

Method: This cross-sectional study was conducted at Aarhus University in March 2023. Eligible candidates were consecutive subjects with juvenile idiopathic arthritis (JIA) and temporomandibular joint involvement accompanied by a parental proxy for examination in the Craniofacial Clinic. After obtaining written informed consent, the questionnaire was completed individually and separately by the child and the parent without any communication between them. The level of agreement was analysed using Cohen's (weighted) kappa for nominal and ordinal outcome variables (orofacial pain frequency, pain location, jaw function, orofacial symptoms, and changes since last visit) and the intraclass correlation coefficient for linear outcome variables (orofacial pain intensity and functional disability of the jaw).

Results: The 34 included dyads had an overall 'poor' to 'moderate' child-proxy reporting agreement on the questionnaire for the assessment of JIA-related orofacial symptoms. After dividing the children into two age groups, < 13 and ≥ 13 years old, we found substantial agreement on pain frequency and moderate to excellent agreement on pain intensity for the older group. The child-proxy agreement for children aged < 13 years was slight on pain frequency and poor to moderate on pain intensity.

Conclusion: The child-proxy reporting agreement on JIA-related orofacial symptoms is inconsistent. We suggest collecting information from both children and parents, especially when assessing orofacial pain and symptoms in children < 13 years of age.

Objective: Although gout is the most common inflammatory arthritis, there are few tools to monitor disease activity and predict complications in gout patients. The neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are associated with disease activity in various diseases and the NLR has been shown to predict coronary artery disease severity, a common comorbid condition with gout. Thus, we evaluated the use of NLR and MLR as novel biomarkers to measure disease activity and predict cardiovascular disease (CVD) risk in gout patients.

Method: Data were collected from 38 gout patients. Disease activity, including total number of acute gout attacks, and 10 year risk of cardiovascular morbidity, were assessed at the patient's visit. Calprotectin, cell counts, and uric acid levels were measured from patients' blood.

Results: Levels of the neutrophil activation marker calprotectin correlated with NLR (r = 0.56, p = 0.0004). MLR correlated with total number of gout attacks as well (r = 0.39, p = 0.02). NLR and MLR, but not absolute monocyte or neutrophil counts, were significantly correlated with body mass index and significantly increased in gout patients with high CVD risk (p < 0.05). Using logistic regression analysis, patients with high NLR or MLR (defined as the upper quartile of patients) had increased odds of developing high CVD risk (odds ratio 7.5, 95% confidence interval 1.7-33.0).

Conclusion: NLR and MLR are potential biomarkers to predict gout flare risk. An increase in either may indicate an increased risk of CVD morbidity.

Objective: In systemic lupus erythematosus (SLE), the non-classical monocyte compartment is expanded, but its phenotype and association with clinical disease manifestations have not been explored.

Method: Monocyte subsets from 39 SLE patients, 32 healthy age-matched controls, and 16 patients from a disease control (autoimmune connective tissue disease other than SLE) were determined based on CD14 and CD16 surface expression. Cell surface expression of the receptors for macrophage colony-stimulating factor (M-CSF) (CD115) and granulocyte-macrophage colony-stimulating factor (GM-CSF) (CD116), as well as 6-Sulpho LacNAc (slan), were analysed by flow cytometry. The association of monocyte populations with disease manifestations, disease activity markers, and current medication of each patient was analysed by chart review.

Results: Non-classical monocytes displayed a cell-type specific signature of high M-CSF receptor CD115 and low GM-CSF receptor CD116 expression that separated them from the other two monocyte subsets. In healthy individuals, the M-CSF receptor on non-classical monocytes was an age-dependent surface marker, with lower expression in young adults. However, SLE monocytes were characterized by a marked expansion of M-CSF receptor/CD115⁺ non-classical monocytes in patients of all ages. The expanded population of M-CSF receptor/CD115⁺ non-classical monocytes was associated with lupus nephritis but not with disease activity, and coexpressed slan.

Conclusion: The non-classical monocyte subset in SLE is characterized by an expansion of M-CSF receptor/CD115⁺ cells that are associated with lupus nephritis and coexpress slan.

Objective: Diabetic cheiroarthropathy (DCA) is one of the musculoskeletal manifestations of diabetes mellitus. It is clinically diagnosed using the prayer and tabletop signs. The clinical appearance, however, mimics autoimmune-mediated polyarthritis of the hands and fingers. It is therefore crucial to positively identify DCA patients.

Method: We used high-frequency B-mode ultrasound to investigate 14 patients with DCA and seven non-DCA diabetics with anti-cyclic citrullinated peptide antibody-positive rheumatoid arthritis (RA). We recorded the frequency of synovitis in radiocarpal, metacarpophalangeal, and proximal interphalangeal joints, the presence of tenosynovitis of the finger flexor tendons, echogenicity of the synovia and the flexor tendon sheaths, and soft tissue alterations in the digits. We compared our findings between groups to determine sonographic characteristics of DCA.

Results: A low rate of small finger joint involvement in the presence of a high rate of finger flexor tendinopathy showed a high association with DCA in correlation (p = 0.002) and regression analysis (p < 0.001). Tendon sheaths were significantly more often hyperechoic and proliferative in DCA compared to RA (p = 0.008), and hypoechoic soft tissue alterations were almost exclusively seen in DCA patients (p = 0.003). Radiocarpal joint involvement and its echogenicity did not differ between groups.

Conclusion: Ultrasonography shows typical features in DCA, and is capable of discriminating DCA from non-DCA patients with RA and diabetes.

Objectives: To assess the longitudinal association between physical activity and global functioning in patients with axial spondyloarthritis (axSpA), and to identify the subtype of physical activity that is longitudinally related to global functioning.

Method: Physical activity was measured using Global Physical Activity Questionnaire. Global functioning was assessed using the Assessment of SpondyloArthritis international Society Health Index (ASAS HI). The amount and subtype (work, transport, and recreation) of physical activity, disease activity, and ASAS HI were assessed at baseline, and at 1 and 2 year follow-up. Physical activity levels were categorized as low, moderate, or high. The longitudinal association between physical activity and ASAS HI scores was analysed using a generalized estimating equation.

Results: The study evaluated 160 patients. Univariate analysis identified physical activity at moderate level and higher, Ankylosing Spondylitis Disease Activity Score (ASDAS), and syndesmophyte number as being longitudinally associated with ASAS HI over 2 years. Multivariate analysis identified physical activity at moderate level and higher as being longitudinally associated with ASAS HI. Physical activity above moderate levels was associated independently with good global functioning. In the analysis stratified by radiographic axSpA and non-radiographic axSpA, a positive association between physical activity and global functioning was observed in both groups. Only recreational activity, but not work- and transport-related activity, showed an independent longitudinal relationship with the ASAS HI score.

Conclusions: Physical activity at moderate level and higher was associated independently with global functioning in axSpA. Therefore, patients should maintain physical activity above moderate levels to preserve global function.