Evidence for Alternatively Activated (M2) Macrophage Activation in Patients with Enthesitis Related Arthritis Category of Juvenile Idiopathic Arthritis

Amita Aggarwal¹, Priyanka Gaur² and Akhilesh Yadav³, ¹Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, ²Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, ³Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Inflammation, innate immunity, Juvenile Arthritis, macrophages and spondylarthropathy

Session Information

Date: Tuesday, November 7, 2017

Title: Pediatric Rheumatology – Pathogenesis and Genetics Poster

Session Type: ACR Poster Session C

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

Background/Purpose:

Among juvenile idiopathic arthritis (JIA), enthesitis related arthritis (ERA) category includes most children with juvenile onset spondyloarthropathy (SpA). Synovial fluid from patients with SpA causes more M2 polarization of peripheral blood monocytes than SF from patients with RA. Recently an increase in CD163+ macrophages was seen in ileal biopsies from patients with AS. A 6.5 fold higher expression of CD163 has been reported in SFMC gene expression as compared to PBMC of children with ERA. Thus we studied levels of sCD163 as a marker of activation of M2 macrophages in serum and synovial fluid of children with ERA.

Methods:

Serum samples from patients with ERA and healthy young adults were assayed for sCD163 using ELISA (R&D systems). In addition SF from children with ERA was also analyzed where available.

Results:

Sera from 85 patients and synovial fluid from 32 patients with ERA and serum from 46 young adults were analyzed. The average age of patients at inclusion was 16+3.24 years and age at onset was 11.2+2.79 years. 79 of them were boys and HLA B27 was positive in 64/80 patients (data not available in 5)

The mean serum sCD163 levels were higher in patients as compared to healthy controls (1433.61 +1256.11 versus 907.35+726.56ng/ml; p<0.001). The synovial fluid levels were much higher than serum levels (4307.38+3363.92 ng/ml; p<0.003). Data on disease activity was available in 56 patients. The mean TJC was 3+2.7, SJC was 2.3+2.2, ESR was 74+34 mm and CRP was 6.98+5.4 mg/dl. The serum levels of sCD163 did not have any correlation with disease activity parameters.

Conclusion:

A higher levels of sCD163 in serum of patients with ERA and even higher levels in paired SF suggest that there is activation of alternatively activated macrophages in ERA. Lack of correlation with activity may suggest that they have immune regulatory role in patients with ERA.

Disclosure: A. Aggarwal, None; P. Gaur, None; A. Yadav, None.

To cite this abstract in AMA style:

Aggarwal A, Gaur P, Yadav A. Evidence for Alternatively Activated (M2) Macrophage Activation in Patients with Enthesitis Related Arthritis Category of Juvenile Idiopathic Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/evidence-for-alternatively-activated-m2-macrophage-activation-in-patients-with-enthesitis-related-arthritis-category-of-juvenile-idiopathic-arthritis/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evidence-for-alternatively-activated-m2-macrophage-activation-in-patients-with-enthesitis-related-arthritis-category-of-juvenile-idiopathic-arthritis/