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 . 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
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 December 13, 2019.
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