In:
Arthritis & Rheumatology, Wiley, Vol. 70, No. 4 ( 2018-04), p. 606-615
Abstract:
To investigate whether abnormalities in B cell subsets in patients with juvenile idiopathic arthritis ( JIA ) correlate with clinical features and response to treatment. Methods A total of 109 patients diagnosed as having oligoarticular JIA or polyarticular JIA were enrolled in the study. B cell subsets in peripheral blood and synovial fluid were analyzed by flow cytometry. Results Switched memory B cells were significantly increased in patients compared to age‐matched healthy controls ( P 〈 0.0001). When patients were divided according to age at onset of JIA , in patients with early‐onset disease (presenting before age 6 years) the expansion in switched memory B cells was more pronounced than that in patients with late‐onset disease and persisted throughout the disease course. In longitudinal studies, during methotrexate ( MTX ) treatment, regardless of the presence or absence of active disease, the number of switched memory B cells increased significantly (median change from baseline 36% [interquartile range {IQR} 15, 66]). During treatment with MTX plus tumor necrosis factor inhibitors ( TNF i), in patients maintaining disease remission, the increase in switched memory B cells was significantly lower than that in patients who experienced active disease (median change from baseline 4% [IQR −6, 32] versus 41% [IQR 11, 73] ; P = 0.004). The yearly rate of increases in switched memory B cells was 1.5% in healthy controls, 1.2% in patients who maintained remission during treatment with MTX plus TNF i, 4.7% in patients who experienced active disease during treatment with MTX plus TNF i, and ~4% in patients treated with MTX alone. Conclusion Switched memory B cells expand during the disease course at a faster rate in JIA patients than in healthy children. This increase is more evident in patients with early‐onset JIA . TNF i treatment inhibits this increase in patients who achieve and maintain remission, but not in those with active disease.
Type of Medium:
Online Resource
ISSN:
2326-5191
,
2326-5205
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2754614-7
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