ScholarWorks@숙명여자대학교

초록

Objective CD4(+) T cells are crucial for the pathogenesis of rheumatoid arthritis (RA). Here, we evaluated gene expression in CD4(+) T cells in early RA, and main purpose of present study was to seek the changes in CD4(+) T-cell-related cytokines according to RA progression. Methods Early RA was defined as methotrexate (MTX)-naive patients. Established RA was defined as patients with more than 6 months of DMARDs. Patients with osteoarthritis were evaluated as controls. Microarray analysis was used to identify overexpressed genes in CD4(+) T cells, and RT-qPCR was used to validate. Plasma cytokine were measured in patients with early and established RA, and correlations with disease activity were assessed in patients with early RA, whereas clinical prognosis was assessed in established patients with RA. Results Thirty-four genes showed overexpression in CD4(+) T cells from patients with early RA compared with OA controls. Nineteen were related to interferon (IFN)-gamma, and eight were related to interleukin (IL)-17A. Plasma levels of IL-17A, IL-6, IL-12, and TNF-alpha correlated with IFN-gamma, and correlation coefficient was highest between DAS28-ESR and plasma IFN-gamma levels in patients with early RA (Rho=0.553, p=0.0025). In established RA with low disease activity, drug reduction group showed lower plasma IFN-gamma and IL-17A than drug maintenance/relapse group (13.61 +/- 5.75 vs. 29.89 +/- 18.72, p<0.001; and 10.91 +/- 3.92 vs. 21.04 +/- 12.81 pg/mL, p<0.001, respectively). Conclusion The IFN-gamma and IL-17 gene signature in CD4(+) T cells was significantly increased in early RA. Patients with established RA with low levels of IFN-gamma and IL-17A could be eligible for dose reduction.

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