The Immunophenotyping of Peripheral Blood Associates with Nailfold Microvascular Changes in Patients with Systemic Sclerosis

Satoshi Kubo¹, Shingo Nakayamada², Maiko Yoshikawa¹, Yusuke Miyazaki¹, Hiroko Yoshinari³, Yurie Satoh³, Yasuyuki Todoroki³, Kazuhisa Nakano², Shigeru Iwata⁴, Kentaro Hanami¹, Shunsuke Fukuyo³, Ippei Miyagawa⁵, Minoru Satoh⁶ and Yoshiya Tanaka⁷, ¹The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan, ²First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan, ³University of Occupational and Environmental Health, Japan, Fukuoka, Japan, ⁴First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan, ⁵University of Occupational and Environmental Health, Japan, Kitakyushu, Japan, ⁶Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan, ⁷The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords: B cells, nailfold capillaroscopy and systemic sclerosis, T cells

Session Information

Date: Sunday, November 5, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Pathogenesis, Animal Models and Genetics Poster I

Session Type: ACR Poster Session A

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

The immunophenotyping of peripheral blood associates with nailfold microvascular changes in patients with systemic sclerosis

Background/Purpose: Systemic sclerosis (SSc) is a complex disease with autoimmunity and vasculopathy, leading to subsequent fibrosis. However, little is known about the relationship between immunological abnormality and microvascular changes. Here, we stratified SSc patients based on peripheral immunophenotyping and investigated the association between immunophenotyping and vasculopathy in SSc.

Methods: Ninety patients with SSc were enrolled in this study. Nailfold videocapillaroscopy was performed for qualitative assessment of morphological microvascular. Peripheral blood mononuclear cells were obtained and the phenotype of circulating B, T, NK and dendritic cells was defined based on flow cytometric analysis for human immune system termed "the Human Immunology Project". Based on these results, SSc patients were classified into subgroups by cluster analysis.

Results: The proportion of effector T cell was higher in SSc than the healthy control. The proportion of activated Th1 (2.0% vs 1.3%) and activated Th17 (1.2% vs 0.8%), but not Treg and Tfh, was higher in SSc. On the other hand, the abnormalities of B cell differentiation in SSc patients were mild. The proportion of plasmablast was comparable and that of naïve B cell was higher in SSc. However, cluster analysis stratified SSc patients into three subgroups (Figure): patients who showed almost normal immunophenotype (without abnormality group), patients with high percentage of effector T cell and Th17 cells (T cell-dominant group), and patients with high proportion of plasmablast and effector B cell (B cell-dominant group). The majority (81%) of SSc patients belonged to the without abnormality group. In contrast, the percentage of patients who had severe microvascular changes was highest among the T cell-dominant group and the B cell-dominant group.

Conclusion: Immune abnormality in peripheral blood was not necessarily found in all cases of SSc. However, our data indicated that there are two types of immunological abnormalities associated with the risk of vasculopathy in patients with SSc. Accumulation of further evidence will not only contribute to elucidate the pathogenesis of SSc but also help the development of targeted therapy.

Figure. Immune cell characteristics based on statistical cluster analysis in patients with systemic sclerosis: Immunophenotypes of the three groups. P values by one-way analysis of variance.

Disclosure: S. Kubo, Bristol-Myers Squibb, 8,Pfizer Inc, 8,Takeda Pharmaceutical Company Ltd, 8; S. Nakayamada, Bristol-Myers Squibb, 8; M. Yoshikawa, None; Y. Miyazaki, None; H. Yoshinari, None; Y. Satoh, None; Y. Todoroki, None; K. Nakano, None; S. Iwata, None; K. Hanami, None; S. Fukuyo, None; I. Miyagawa, None; M. Satoh, None; Y. Tanaka, Mitsubishi-Tanabe, Takeda, Bristol-Myers, Chugai, Astellas, Abbvie, MSD, Daiichi-Sankyo, Pfizer, Kyowa- Kirin, Eisai, Ono, 2,Daiichi-Sankyo, Astellas, Pfizer, Mitsubishi-Tanabe, Bristol-Myers, Chugai, YL Biologics, Eli Lilly, Sanofi, Janssen, UCB, 8.

To cite this abstract in AMA style:

Kubo S, Nakayamada S, Yoshikawa M, Miyazaki Y, Yoshinari H, Satoh Y, Todoroki Y, Nakano K, Iwata S, Hanami K, Fukuyo S, Miyagawa I, Satoh M, Tanaka Y. The Immunophenotyping of Peripheral Blood Associates with Nailfold Microvascular Changes in Patients with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/the-immunophenotyping-of-peripheral-blood-associates-with-nailfold-microvascular-changes-in-patients-with-systemic-sclerosis/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-immunophenotyping-of-peripheral-blood-associates-with-nailfold-microvascular-changes-in-patients-with-systemic-sclerosis/