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Abstract Number: 2463

Stromal Cell Markers Are Differentially Expressed in the Synovial Tissue of Patients with Early Arthritis

Ivy Y.K. Choi1, Olga N. Karpus2, Jason D. Turner3, Debbie L. Hardie3, Maria J. H. de Hair1, Karen I. Maijer1, Paul-Peter Tak1,4,5, Karim Raza3,6, Jörg Hamann2, Christopher Buckley3, Danielle Marie Gerlag1,7 and Andrew Filer3,8, 1Division of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands, 2Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands, 3Rheumatology Research Group, MRC Centre for Immune Regulation, School of Immunity and Infection, University of Birmingham, Birmingham, United Kingdom, 4GlaxoSmithKline, Stevenage, United Kingdom, 5University of Cambridge, Cambridge, United Kingdom, 6Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom, 7GlaxoSmithKline, Cambridge, United Kingdom, 8University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Early Rheumatoid Arthritis, outcomes and synovium

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Session Information

Title: Rheumatoid Arthritis - Human Etiology and Pathogenesis

Session Type: Abstract Submissions (ACR)

Background/Purpose

Previous studies have shown increased expression of stromal markers in synovial tissue (ST) of patients with established rheumatoid arthritis (RA). Here, the expression of tissue expressed stromal markers in early arthritis in relationship to diagnosis and outcome was studied.

Methods

ST from 67 patients included in two different early arthritis cohorts (Birmingham and Amsterdam) and seven non-inflammatory controls was analysed using immunofluorescence to detect the stromal markers CD55, CD248, fibroblast activation protein (FAP) and podoplanin. Diagnostic classification (gout, psoriatic arthritis, unclassified arthritis (UA), parvovirus associated arthritis, reactive arthritis and RA) and outcome (resolving or persistent) was determined at baseline and after follow-up. The relationship between the expression of the stromal markers and diagnosis and outcome was determined.

Results

We observed expression of all stromal markers in ST of early arthritis patients, independent of diagnosis or prognostic outcome. Expression of FAP and podoplanin was significantly higher in patients with early RA compared to non-inflammatory controls (p=0.003 and p=0.021, respectively). Significantly greater expression of FAP was found in anti-citrullinated peptide antibody (ACPA)-negative RA patients and in patients with UA fulfilling classification criteria for RA after follow-up compared to patients with resolving disease and patients with persistent disease who did not fulfil classification criteria for RA after follow-up (p=0.030 and p=0.020, respectively for ACPA-negative RA patients and p=0.045 and p=0.024, respectively for UA patients fulfilling classification criteria for RA after follow-up).

Conclusion

The stromal cell markers CD55, CD248, FAP and podoplanin, are expressed in the synovium in the earliest stage of arthritis. Expression of FAP is higher in early unclassified arthritis patients who fulfil classification criteria for RA over time and in ACPA-negative RA compared to resolving or non-RA arthritides. These results suggest that significant fibroblast activation occurs in RA in the early window of disease.


Disclosure:

I. Y. K. Choi,
None;

O. N. Karpus,
None;

J. D. Turner,
None;

D. L. Hardie,
None;

M. J. H. de Hair,
None;

K. I. Maijer,
None;

P. P. Tak,

GlaxoSmithKline,

3;

K. Raza,
None;

J. Hamann,
None;

C. Buckley,
None;

D. M. Gerlag,

GSK,

3;

A. Filer,
None.

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