Low Numbers of CD16+ Monocytes Predict Shorter Time to Relapse in Polymyalgia Rheumatica

Qi Wang¹, Kornelis S.M. van der Geest², Wayel H. Abdulahad¹, Abraham Rutgers¹, Suzanne Arends¹, Annemieke M.H. Boots¹ and Elisabeth Brouwer³, ¹Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands, ²Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands, ³Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, Groningen, Netherlands

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biomarkers, monocytes and polymyalgia rheumatica

Session Information

Date: Sunday, November 13, 2016

Title: Vasculitis - Poster I: Large Vessel Vasculitis and Polymyalgia Rheumatica

Session Type: ACR Poster Session A

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

Background/Purpose: Polymyalgia rheumatica (PMR) is the most frequent inflammatory disorder in persons older than 50 years of age. Biomarkers like ESR and CRP may be associated with a relapse [1-2] but are not disease-specific. Monocytes play an important role in the pathogenesis of PMR and are detected in inflamed tissues (synovia and bursa) of PMR patients. The expression of CD16 (FcR-III) identifies pro-inflammatory monocytes that increase with age, produce IL-6, and are prone to migrate to areas of tissue damage [3]. We hypothesized that down-modulation of peripheral CD16+ monocytes is associated with an emerging relapse in PMR.

Methods: Twenty consecutively recruited, newly-diagnosed, steroid naïve PMR patients fulfilling the Chuang/Hunder criteria were included. Patients were prospectively followed for a median of 3.12 years (range 0.87-4.83 years). Relapses were defined as recurrence of PMR signs and symptoms associated with an increase in ESR (>30mm/h) and/or CRP (>10mg/L) which could not be explained otherwise. Peripheral CD16+ monocytes were enumerated by flowcytometry. Patients were divided into 2 groups based on the median value of CD16+ monocyte counts.

Results: ESR was significantly higher in the group with low CD16+ monocytes compared to the group with high CD16+ monocytes. Therefore, the relation between the numbers of CD16+ monocytes and the ESR was examined and a significant inverse correlation was found (Spearman’s rho=-0.51, p<0.05). Also, PMR patients with low CD16+ monocyte counts were 6-fold more likely to relapse than patients with high CD16+ monocyte counts (HR: 5.96) (Figure 1).

Conclusion: PMR patients with low CD16+ monocyte counts demonstrated a shorter time to relapse. References 1. Kremers HM, Reinalda MS, Crowson CS, Zinsmeister AR, Hunder GG, Gabriel SE. Relapse in a population based cohort of patients with polymyalgia rheumatica. J. Rheumatol. 2005;32(1):65-73 2. Salvarani C, Cantini F, Niccoli L, et al. Acute‐phase reactants and the risk of relapse/recurrence in polymyalgia rheumatica: A prospective followup study. Arthritis Care Res. 2005;53(1):33-38 3. Merino A, Buendia P, Martin-Malo A, Aljama P, Ramirez R, Carracedo J. Senescent CD14+ CD16+ monocytes exhibit proinflammatory and proatherosclerotic activity. J. Immunol. 2011;186(3):1809-15

Disclosure: Q. Wang, None; K. S. M. van der Geest, None; W. H. Abdulahad, None; A. Rutgers, None; S. Arends, None; A. M. H. Boots, None; E. Brouwer, Roche Pharmaceuticals, 5.

To cite this abstract in AMA style:

Wang Q, van der Geest KSM, Abdulahad WH, Rutgers A, Arends S, Boots AMH, Brouwer E. Low Numbers of CD16+ Monocytes Predict Shorter Time to Relapse in Polymyalgia Rheumatica [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/low-numbers-of-cd16-monocytes-predict-shorter-time-to-relapse-in-polymyalgia-rheumatica/. Accessed .

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