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; LXII Reunión de la Sociedad Argentina de Inmunología.; 2014

(404) RELATIONSHIP AMONG NEUTROPHIL COUNTS,AUTOANTIBODY LEVELS AND DISEASE PROGRESSIONIN SYNOVIAL FLUIDS FROM PATIENTS WITH RHEUMATOIDARTHRITISGorlino, Carolina Virginia1; Dave, Mabel Noemí1; Tamashiro,Héctor2; Blas, Rodrigo3; Munarriz, Alicia4; Pistoresi-Palencia, María Cristina5; Di Genaro, María Silvia1Instituto Multidisciplinario de Investigaciones Biológicas(IMIBIO)-CONICET-UNSL1 Clínica Bolívar2 MEDICI3 InstitutoPrivado Cenyr4 Centro de Investigaciones en BioquímicaClínica e Inmunología (CIBICI)-CONICET-UNC5Rheumatoid arthritis (RA), one of the most frequent autoimmunedisease, is a chronic inflammatory rheumatism hallmarked byprogressive and irreversible joint destruction. Among the numerousautoantibodies associated with RA, anti-cyclic citrullinated peptideantibodies (ACPA) are now recognized as the most diseasespecific.The aim of this study was to determine the relationshipbetween neutrophil infiltration into inflamed joints and the presenceof ACPA in RA patients. Synovial fluid (SF) samples were obtainedfrom 42 patients (Male/Female: 8/34; mean age: 53±13 years) whofull-filled the American College of Rheumatology/European LeagueAgainst Rheumatism (ACR/EULAR) RA classification criteria. Allpatients gave informed consent and the protocol of the study wasapproved by the ethic board of IBYME (CE 003-2/2013). Diseaseactivity was evaluated by 28-joint count Disease Activity Score(DAS-28) and erythrocyte sedimentation rate (ESR) was determinedby Westergren method. Immunoglobulin G (IgG) ACPA weremeasured using QuantaLite CCP3 ELISA kit and total IgG levelswere determined by radial immunodiffusion assay. We found thatneutrophil numbers infiltrating inflamed joints correlated positivelywith DAS-28, suggesting that the presence of high numbers ofthese cells is related with severe disease manifestations (p<0.05).Although SF-total IgG levels were negatively correlated with diseaseactivity (p<0.05), the ratio of ACPA/total IgG showed a positivecorrelation (p<0.05), demonstrating that ACPA levels are increasedin relation to total IgG concentrations in SF from patients withworse clinical manifestations. The findings of this study indicatea correlation among disease activity, neutrophil infiltration andlevels of ACPA antibodies in inflamed joints of RA patients. Wepropose that neutrophil counts in SF, together with ACPA/total IgGdetermination, may serve as prognostic factor for RA progression.