Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Immune cell activation plays a crucial role in the pathogenesis of systemic sclerosis (SSc), and macrophages may be important mediators in this complex pathway (1,2). In SSc patients (pts), alternatively activated macrophages (M2) are present in the skin infiltrate, contributing to dermal fibrosis (2). M2 may differentiate from peripheral blood monocytes (PBMs), and are characterized by the expression of specific phenotype markers, such as CD206 (mannose receptor-1), and CD204 (macrophage scavenger receptor) (1). The study investigated the percentages of circulating CD206+/CD204+PBMs in SSc pts and possible correlations with specific clinical parameters.
Methods: Sera from forty-one SSc pts (36 females/5 males, mean age 62±15 years), who fulfilled the new EULAR/ACR criteria (3), and twenty voluntary healthy subjects (HS – 16 females/4 males, 61±10 years) were collected after EC approval and Informed Consent signed. Lung involvement (DLCO) and specific SSc autoantibodies (anti-centromere/CENP; anti-topoisomerase/Scl70; RNApoly3; fibrillarin; Th/Th0; PM-Scl75) were analysed. Nailfold videocapillaroscopy (NVC) was performed to define the pattern of microangiopathy. PBMs from SSc pts and HS were evaluated by flow cytometry (FC) by investigating cell positive for CD14 (monocyte/macrophage marker), CD206 and CD204. The statistical analysis was carried out using Mann-Whitney non-parametric U-test and correlation test.
Results: Among the 41 SSc pts, 27 showed a “limited” cutaneous involvement (lSSc) and 14 a “diffuse” cutaneous involvement (dSSc). The analysis of specific auto-antibodies yielded 13 pts positive for CENP, 16 pts positive for Scl70, 6 pts positive for the other investigated autoantibodies. Six pts were found Ab negative and excluded from the study. The evaluation by FC of circulating CD14+cells did not show any significant difference between SSc patients and HS. However, in the CD14+cell subset the percentage of CD206+CD204+cells was significantly increased in SSc pts compared to HS (p=0.02). The percentage of these cells was increased in lSSc pts (p=0.06), but significantly increased in dSSc pts (p=0.03) and inversely correlated with DLCO (p=0.032, R=0.13). In addition, CD206+CD204+cells were increased in Scl70-positive pts and significantly increased in CENP positive pts (p=0.011). NVC analysis identified 12 SSc pts with an “early” pattern, 14 pts with an “active” pattern and 16 pts with a “late” pattern. The percentage of CD206+CD204+cells was increased in pts with “early” or “late” NVC pattern (p=0.09, p=0.06) but significantly increased in those with the “active” pattern compared to HS (p=0.04).
Conclusion: The results confirmed the presence of an increased percentage of cells with an M2 phenotype in the peripheral blood of SSc pts. M2 cells seem to correlate with specific lung and skin involvement, autoantibody positivity and an “active” NVC pattern of microangiopathy. References: 1 Higashi-Kuwata N et al. Arthritis Res Ther 2010:12:R128. 2 Nakayama W et al. Rheumatol Int 2012;32:403–7. 3 van der Hoogen F et al. Arthrit Rheum 2013;65:2737-47.
To cite this abstract in AMA style:Soldano S, Contini P, Trombetta AC, Ruaro B, Paolino S, Pizzorni C, Brizzolara R, Montagna P, Sulli A, Cutolo M. Increased Percentage of CD204/CD206 Double Positive Monocytes Correlates with Specific Lung and Skin Involvement Parameters and an “Active” Capillaroscopic Pattern of Microangiopathy in Systemic Sclerosis Patients [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/increased-percentage-of-cd204cd206-double-positive-monocytes-correlates-with-specific-lung-and-skin-involvement-parameters-and-an-active-capillaroscopic-pattern-of-microangiopathy-i/. Accessed December 5, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-percentage-of-cd204cd206-double-positive-monocytes-correlates-with-specific-lung-and-skin-involvement-parameters-and-an-active-capillaroscopic-pattern-of-microangiopathy-i/