Relationship among neutrophil counts, autoantibody levels and disease progression in synovial fluids from patients with rheumatoid arthritis.

GORLINO, C; DAVE M; TAMASHIRO, H; BLAS, R; MUNARRIZ A; PISTORESI, MC; DI GENARO, S

Mar del Plata

Congreso; LIX Reunión Científica de Inmunología.; 2014

Sociedad Argentina de Inmunología.

Rheumatoid arthritis (RA), one of the most frequent autoimmune disease, is a chronic inflammatory rheumatism hallmarked by progressive and irreversible joint destruction. Among the numerous autoantibodies associated with RA, anti-cyclic citrullinated peptide antibodies (ACPA) are now recognized as the most diseasespecific. The aim of this study was to determine the relationship between neutrophil infiltration into inflamed joints and the presence of ACPA in RA patients. Synovial fluid (SF) samples were obtained from 42 patients (Male/Female: 8/34; mean age: 53±13 years) who full-filled the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA classification criteria. All patients gave informed consent and the protocol of the study was approved by the ethic board of IBYME (CE 003-2/2013). Disease activity was evaluated by 28-joint count Disease Activity Score (DAS-28) and erythrocyte sedimentation rate (ESR) was determined by Westergren method. Immunoglobulin G (IgG) ACPA were measured using QuantaLite CCP3 ELISA kit and total IgG levels were determined by radial immunodiffusion assay. We found that neutrophil numbers infiltrating inflamed joints correlated positively with DAS-28, suggesting that the presence of high numbers of these cells is related with severe disease manifestations (p<0.05). Although SF-total IgG levels were negatively correlated with disease activity (p<0.05), the ratio of ACPA/total IgG showed a positive correlation (p<0.05), demonstrating that ACPA levels are increased in relation to total IgG concentrations in SF from patients with worse clinical manifestations. The findings of this study indicate a correlation among disease activity, neutrophil infiltration and levels of ACPA antibodies in inflamed joints of RA patients. We propose that neutrophil counts in SF, together with ACPA/total IgG determination, may serve as prognostic factor for RA progression.