Journal
ANNALS OF THE RHEUMATIC DISEASES
Volume 68, Issue 5, Pages 751-756Publisher
B M J PUBLISHING GROUP
DOI: 10.1136/ard.2008.089284
Keywords
-
Categories
Funding
- Fondo de Investigacion Sanitaria, Ministerio de Sanidad y Consumo [FIS 04/1023, 04/1027, 05/983, 05/60]
- Fundacion Espanola de Reumatologia/Abbot Laboratories
- Hospital Clinic de Barcelona
- EI
Ask authors/readers for more resources
Objective: To investigate the clinical significance of lymphoid neogenesis (LN) in rheumatoid arthritis ( RA), the clinicopathological correlates of this process and its evolution after anti-tumour necrosis factor (TNF)alpha therapy in a large series of synovial tissues were analysed. Methods: Arthroscopic synovial biopsies from 86 patients with RA were analysed by immunohistochemistry. LN was defined as the presence of large aggregates of lymphocytes with T/B cell compartmentalisation and peripheral node addressin ( PNAd) positive high endothelial venules. Clinical variables at baseline and after prospective follow-up were compared in LN positive and negative RA subsets. The evolution of LN and its correlation with the clinical course in a subgroup of 24 patients that underwent a second arthroscopic biopsy after anti-TNF alpha therapy was also analysed. Results: LN was present in 49% of RA synovial tissues. Patients with LN had a significantly higher disease duration and a higher previous use of anti-TNF alpha agents. During prospective follow-up, the proportion of patients achieving good or moderate European League Against Rheumatism (EULAR) 28-joint Disease Activity Score (DAS28) responses was significantly lower in patients who were LN positive despite a significantly higher use of anti-TNF alpha agents. By multivariate logistic regression analysis, LN remained as an independent negative predictor of response to therapy. In the subgroup of patients rebiopsied after anti-TNF alpha therapy, reversal of LN features occurred in 56% of the patients and correlated with good clinical responses. Conclusions: Synovial LN in RA predicts a lower response to therapy. LN features can be reversed after a short period of anti-TNF alpha therapy in parallel to good clinical responses.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available