ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 359

Characterization of Lymphoid Cells in Synovial Fluid from Cancer Patients with Immunotherapy-Induced Arthritis

Sang Kim1, Jean Tayar1, Huifang Lu1, Jennifer Wang2, Don Gibbons3, Guillermo Garcia-Manero4, Patrick Hwu5, Adi Diab5 and Roza Nurieva6, 1General Internal Medicine (Rheumatology), MD Anderson Cancer Center, Houston, TX, 2Genitourinary Medical Oncology, MD Anderson Cancer Center, Houston, TX, 3Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX, 4Leukemia, MD Anderson Cancer Center, Houston, TX, 5Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, 6Immunology, MD Anderson Cancer Center, Houston, TX

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Arthritis, Cancer treatments, lymphocytes and synovial fluid, T cells

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I: Checkpoint Inhibitors, Retroperitoneal Fibrosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Checkpoint inhibitors (ICIs) are revolutionizing cancer treatment; however, ICI therapy is associated with immune-related adverse events (irAEs). irAEs can be life-threatening and/or severely impair quality of life, necessitating early termination of ICI treatment. Two percent of cancer patients who receive ICI treatment develop arthritis as an irAE (arthritis-irAE). Prompt diagnosis and early intervention are critical in the management of irAE; however, detailed characterization of immune cells in the inflamed tissues, the first step in elucidating the mechanisms of irAEs, is still lacking. Here, we characterize synovial immune cells isolated from patients with arthritis-irAE.

Methods:

We analyzed synovial fluid from five patients with arthritis-irAE. As a control, we also analyzed one anonymous pediatric tonsil. We stained lymphoid immune cells with lineage-specific markers and measured effector cytokines in the CD4+ T cell populations.

Results:

Arthritis developed an average of 270±375 days after the first ICI infusion. Two of the five patients developed arthritis after completion of ICI treatment. Arthritis was treated with systemic prednisone and/or local injection. Three patients achieved complete resolution of arthritis (“steroid responders”) while two patients had suboptimal response and needed additional treatment (“steroid non-responders”). The most abundant lymphoid immune cells were CD4+ T cells (53.1±13.2% of live immune cells), followed by CD8+ T cells, NK cells, γδ T cells, NK T cells, and B cells. Most CD8+ T cells were effector memory or terminally differentiated effector memory cells. All CD4+ T cell subsets were identified in the synovial fluid, including regulatory T cells (Treg), naïve T cells, Th1 (CXCR3hi CCR6hi), Th1.17 (CXCR3hi CCR6hi), Th17 (CXCR3lo CCR6hi), and follicular helper T cells (CXCR5+). Effector CD4+ T cell cytokines, including interferon gamma, IL-4, IL-17, and IL-21, were produced by both Tregs and non-Tregs. Interestingly, IL-17+ non-Treg cells were expanded in steroid non-responders compared to steroid responders, indicating that Th17 cells might play a critical role in persistent arthritis-irAE.

Conclusion:

Our results suggest that arthritis-irAE can develop at any time during or after the ICI treatment. The observed expansion of IL-17+ non-Treg cells in synovial fluid from steroid non-responders suggests that Th17 cells might play a key role in the pathogenesis of arthritis-irAE. Understanding of Th17 CD4+ cell biology will provide therapeutic targets and reliable biomarkers for arthritis-irAEs.


Disclosure: S. Kim, None; J. Tayar, None; H. Lu, None; J. Wang, None; D. Gibbons, None; G. Garcia-Manero, None; P. Hwu, None; A. Diab, None; R. Nurieva, None.

To cite this abstract in AMA style:

Kim S, Tayar J, Lu H, Wang J, Gibbons D, Garcia-Manero G, Hwu P, Diab A, Nurieva R. Characterization of Lymphoid Cells in Synovial Fluid from Cancer Patients with Immunotherapy-Induced Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/characterization-of-lymphoid-cells-in-synovial-fluid-from-cancer-patients-with-immunotherapy-induced-arthritis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/characterization-of-lymphoid-cells-in-synovial-fluid-from-cancer-patients-with-immunotherapy-induced-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology