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Abstract Number: 28

Sapril and Sbcma As Potential Biomarkers of B Cell Hyperactivation in Rheumatoid Arthritis: A Cluster Analysis Approach

Javier Rodríguez-Carrio1, Mercedes Alperi-López2, Patricia López1, Francisco Javier Ballina-García3 and Ana Suárez1, 1Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain, 2Department of Rheumatology, Hospital Universitario Central de Asturias, Asturias, Spain, 3Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: APRIL, B cells, BAFF and arthritis

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Session Information

Date: Sunday, November 5, 2017

Session Title: B Cell Biology and Targets in Autoimmune Disease Poster

Session Type: ACR Poster Session A

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

Background/Purpose: B cell compartment plays a key role in the pathogenesis of rheumatoid arthritis (RA). Activation and survival of B cell largely rely on the BLyS-APRIL system, including ligands and receptors, both expressed as membrane (m) and soluble (s) forms. The main aim of this study was to analyze the role of the BLyS-APRIL system in RA, with a special focus on its clinical relevance.

Methods: sBLyS, sAPRIL, sBCMA, sTACI, IFNα, MIP1α, TNFα, IL-10, IFNγ, IL-8, IL-37 and GM-CSF levels were measured by immunoassays in serum samples from 104 RA patients (EULAR/ACR 2010 criteria) and 33 healthy controls (HC). The membrane BLyS (mBLyS) expression was assessed on B cells, monocytes (MØ), myeloid (mDC) and plasmacytoid (pDC) dendritic cells and neutrophils (NØ) by flow cytometry in blood samples. A group of biological-naïve RA patients was prospectively followed for 3 months upon TNFα-blockade.

Results: RA patients exhibited increased sAPRIL (p<0.001) and sBCMA serum levels (p=0.002) than HC. sBLyS was higher in patients with early arthritis (recruited at onset) compared to those with long-standing disease (p=0.051) and HC (p=0.024). Levels of sTACI did not differ between patients and controls (p=0.462). mBLyS expression was increased on B cells (p=0.002), MØ (p<0.001), mDC (p<0.001) and NØ (p=0.014) in RA. By means of an unsupervised cluster analysis based on sBLyS, sAPRIL, sBCMA and sTACI, two clusters were identified (clusters I and II), cluster II being hallmarked by increased sAPRIL and sBCMA serum levels. Cluster II was found in 26 (25.0%) RA patients but was not observed in the HC group (p=0.001). Cluster II RA patients showed increased RF (p=0.002) and ACPA (p=0.001) positivity and were less likely to be treated with methotrexate (p=0.028) but more likely with anti-TNFα agents (p=0.013) compared to their cluster I counterparts. Cluster II was associated with higher DAS28 (p<0.050) but no difference in disease duration was observed (p=0.159). Additionally, higher IL-10 (p=0.060), IFNα (p=0.005), MIP1α (p=0.042), TNFα (p=0.006) and GM-CSF (p=0.008) levels were registered in cluster II. Further analyses revealed that sTACI was negatively associated with DAS28 score (r=-0.283, p=0.014) and positively with IL-10 serum levels (r=0.233, p=0.040) in patients within cluster I. On the contrary, in cluster II, APRIL was positively correlated with mBLyS expression on B cells (r=0.786, p=0.036), whereas sBLyS was associated with DAS28 (r=0.281, p=0.016). Also, IFNα serum levels paralleled those of sTACI (r=-0.636, p<0.001) in these patients. Finally, increasing sBLyS (p=0.043) and sBCMA levels (p=0.019) upon TNFα-blockade were associated with poor clinical outcome.

Conclusion: APRIL and sBCMA identify a subset of patients with a more severe disease, probably linked to a B cell hyperactivation status. APRIL and sBCMA may be promising biomarkers for patient stratification to B-cell targeted therapy in RA.


Disclosure: J. Rodríguez-Carrio, None; M. Alperi-López, None; P. López, None; F. J. Ballina-García, None; A. Suárez, None.

To cite this abstract in AMA style:

Rodríguez-Carrio J, Alperi-López M, López P, Ballina-García FJ, Suárez A. Sapril and Sbcma As Potential Biomarkers of B Cell Hyperactivation in Rheumatoid Arthritis: A Cluster Analysis Approach [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/sapril-and-sbcma-as-potential-biomarkers-of-b-cell-hyperactivation-in-rheumatoid-arthritis-a-cluster-analysis-approach/. Accessed January 17, 2021.
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