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Arias de la Rosa I, Escudero-Contreras A, Ruiz-Ponce M, Román-Rodríguez C, Pérez-Sánchez C, Ábalos-Aguilera MDC, Ortega-Castro R, Alcaide J, Murri M, Font P, Calvo-Gutiérrez J, Luque-Tevar M, Patiño-Trives AM, Guzmán-Ruiz R, Malagón MDM, Tinahones FJ, Collantes-Estévez E, López-Pedrera C, Barbarroja N. Molecular Changes in the Adipose Tissue Induced by Rheumatoid Arthritis: Effects of Disease-Modifying Anti-Rheumatic Drugs. Front Immunol 2021; 12:744022. [PMID: 34721412 PMCID: PMC8549628 DOI: 10.3389/fimmu.2021.744022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/13/2021] [Indexed: 02/01/2023] Open
Abstract
Disease severity, progression and response to therapy might be worse in obese rheumatoid arthritis (RA) patients, but paradoxically, obesity also might protect from radiographic joint damage. Thus, the intricate relationship between obesity and RA needs urgent clarification. The aim of this study was to assess the influence of obesity on the onset and development of RA and to determine whether arthritis could modify the adipose tissue biology and whether conventional Disease Modifying Anti-Rheumatic Drugs (cDMARDs) can modulate these alterations. Two strategies were followed: (1) clinical profiling of two cohorts of RA: non-obese and obese patients; and (2) mechanistic studies carried out in both a collagen-induced arthritis (CIA) in an obese mouse model and 3T3-L1 adipocytes treated with cDMARDs (leflunomide, methotrexate, and hydroxychloroquine). In our cohort of RA patients with low-moderate disease activity, the presence of obesity was not related to a higher activity of the disease; actually, disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR) was reduced in the obese RA patients. However, the induction of arthritis promoted transcriptomic changes in the adipose tissue under obesity condition in the obese CIA model. Treatment with hydroxychloroquine reduced weight and insulin resistance, accompanied by beneficial metabolic effects in the adipose tissue. These molecular changes in adipose tissue were also observed after methotrexate administration. In sum, arthritis might affect directly the inflammatory burden and metabolic alterations associated with obesity in adipose tissue. Clinicians should be cautious measuring the activity of the disease in obesity and managing the best therapeutic options for the metabolic comorbidities of these patients, where the combination of hydroxychloroquine and methotrexate should be considered to improve adipose tissue dysfunction in obese RA.
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Affiliation(s)
- Iván Arias de la Rosa
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Miriam Ruiz-Ponce
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Cristóbal Román-Rodríguez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Carlos Pérez-Sánchez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - María Del Carmen Ábalos-Aguilera
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Rafaela Ortega-Castro
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Juan Alcaide
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Mora Murri
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Font
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Jerusalem Calvo-Gutiérrez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Maria Luque-Tevar
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Alejandra Maria Patiño-Trives
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Rocío Guzmán-Ruiz
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Maria Del Mar Malagón
- Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Cell Biology, Physiology and Immunology, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Francisco José Tinahones
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Collantes-Estévez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
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2
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Arias de la Rosa I, Font P, Escudero-Contreras A, López-Montilla MD, Pérez-Sánchez C, Ábalos-Aguilera MC, Ladehesa-Pineda L, Ibáñez-Costa A, Torres-Granados C, Jimenez-Gomez Y, Patiño-Trives A, Luque-Tévar M, Castro-Villegas MC, Calvo-Gutiérrez J, Ortega-Castro R, López-Pedrera C, Collantes-Estévez E, Barbarroja N. Complement component 3 as biomarker of disease activity and cardiometabolic risk factor in rheumatoid arthritis and spondyloarthritis. Ther Adv Chronic Dis 2021; 11:2040622320965067. [PMID: 33796240 PMCID: PMC7983248 DOI: 10.1177/2040622320965067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/18/2020] [Indexed: 01/12/2023] Open
Abstract
Objective To analyze the relationship between complement component 3 (C3) and the prevalence of cardiometabolic risk factors and disease activity in the rheumatic diseases having the highest rates of cardiovascular morbidity and mortality: rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). Methods This is a cross-sectional study including 200 RA, 80 PsA, 150 axSpA patients and 100 healthy donors. The prevalence of cardiometabolic risk factors [obesity, insulin resistance, type 2 diabetes mellitus, hyperlipidemia, apolipoprotein B/apolipoprotein A (apoB/apoA) and atherogenic risks and hypertension] was analyzed. Serum complement C3 levels, inflammatory markers and disease activity were evaluated. Cluster analysis was performed to identify different phenotypes. Receiver operating characteristic (ROC) curve analysis to assess the accuracy of complement C3 as biomarker of insulin resistance and disease activity was carried out. Results Levels of complement C3, significantly elevated in RA, axSpA and PsA patients, were associated with the prevalence of cardiometabolic risk factors. Hard clustering analysis identified two distinctive phenotypes of patients depending on the complement C3 levels and insulin sensitivity state. Patients from cluster 1, characterized by high levels of complement C3 displayed increased prevalence of cardiometabolic risk factors and high disease activity. ROC curve analysis showed that non-obesity related complement C3 levels allowed to identify insulin resistant patients. Conclusions Complement C3 is associated with the concomitant increased prevalence of cardiometabolic risk factors in rheumatoid arthritis and spondyloarthritis. Thus, complement C3 should be considered a useful marker of insulin resistance and disease activity in these rheumatic disorders.
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Affiliation(s)
- Iván Arias de la Rosa
- Medicine Department, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Cordoba, Spain
| | - Pilar Font
- Medicine Department, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Cordoba, Spain
| | | | | | - Carlos Pérez-Sánchez
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Lourdes Ladehesa-Pineda
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Carmen Torres-Granados
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Yolanda Jimenez-Gomez
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Alejandra Patiño-Trives
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - María Luque-Tévar
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | | | - Jerusalem Calvo-Gutiérrez
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rafaela Ortega-Castro
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Eduardo Collantes-Estévez
- Rheumatology service, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Nuria Barbarroja
- Medicine Department, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital
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3
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Ladehesa-Pineda ML, Arias de la Rosa I, López Medina C, Castro-Villegas MDC, Ábalos-Aguilera MDC, Ortega-Castro R, Gómez-García I, Seguí-Azpilcueta P, Jiménez-Gómez Y, Escudero-Contreras A, López Pedrera C, Barbarroja N, Collantes-Estévez E. Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis. Ther Adv Musculoskelet Dis 2021; 12:1759720X20982837. [PMID: 33447266 PMCID: PMC7780310 DOI: 10.1177/1759720x20982837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/26/2020] [Indexed: 12/16/2022] Open
Abstract
Aims To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10-0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.
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Affiliation(s)
| | - Iván Arias de la Rosa
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Clementina López Medina
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - María Del Carmen Castro-Villegas
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - María Del Carmen Ábalos-Aguilera
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Rafaela Ortega-Castro
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Ignacio Gómez-García
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Pedro Seguí-Azpilcueta
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Yolanda Jiménez-Gómez
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Chary López Pedrera
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Nuria Barbarroja
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Eduardo Collantes-Estévez
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
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4
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Aranda-Valera IC, Arias de la Rosa I, Roldán-Molina R, Ábalos-Aguilera MDC, Torres-Granados C, Patiño-Trives A, Luque-Tevar M, Ibáñez-Costa A, Guzmán-Ruiz R, Malagón MDM, Escudero-Contreras A, López-Pedrera C, Collantes-Estévez E, Barbarroja N. Subclinical cardiovascular risk signs in adults with juvenile idiopathic arthritis in sustained remission. Pediatr Rheumatol Online J 2020; 18:59. [PMID: 32665015 PMCID: PMC7362625 DOI: 10.1186/s12969-020-00448-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic diseases of childhood that often persists into adulthood and can result in significant long-term morbidity. As a long lasting chronic inflammatory disease, concern has been raised regarding the risk of premature development of cardiovascular disease (CVD) in JIA. This study aims to determine whether adults with JIA in clinical remission display clinical and subclinical signs of CVD risk: inflammatory mediators, adipokines, endothelial dysfunction and oxidative stress markers. METHODS This is a cross-sectional study including 25 patients diagnosed with JIA according to the International League of Associations for Rheumatology criteria (ILAR 2001) and 25 age- and sex-matched controls. Remission was determined by JADAS10 < 1 and according to Wallace criteria. The presence of traditional CVD risk factors was analyzed. An extensive clinical analysis including body mass index (BMI), lipid profile, homeostatic model assessment - insulin resistance (HOMA-IR) and arterial blood pressure was performed. Intima media thickness of the common carotid artery (CIMT) was measured as a marker of subclinical atherosclerosis. Several proinflammatory cytokines, molecules involved in the endothelial dysfunction, oxidative stress and adipokines were quantified on serum by ELISA and on peripheral blood mononuclear cells (PBMCs) by RT-PCR. In vitro studies were carried out in healthy PBMCs, adipocytes and endothelial cells which were treated with serum from JIA patients under sustained remission. RESULTS Mean duration of the disease was 13.47 ± 5.47 years. Mean age was 25.11 ± 7.21. Time in remission was 3.52 ± 3.33 years. Patients were in remission with no treatment (40%) and with treatments (60%). CVD risk factors and CIMT were similar in JIA patients and controls. However, cholesterol levels were significantly elevated in JIA patients. Levels of adipocytokines, oxidative stress and endothelial activation markers were elevated in serum and PBMCs from JIA patients. Serum of those JIA patients induced the activation of adipocytes, endothelial cells and healthy PBMCs. CONCLUSIONS JIA adult patients in remission have subclinical signs of inflammation and CVD risk, showed by an increase in the levels of inflammatory cytokines, endothelial activation and oxidative stress markers and adipokines, molecules closely involved in the alteration of the vascular system.
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Affiliation(s)
| | - Iván Arias de la Rosa
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain ,grid.428865.50000 0004 0445 6160Medicine Department, University of Cordoba/IMIBIC/Reina Sofía University Hospital, Cordoba, Spain
| | - Rosa Roldán-Molina
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - María del Carmen Ábalos-Aguilera
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Carmen Torres-Granados
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Alejandra Patiño-Trives
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - María Luque-Tevar
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Rocío Guzmán-Ruiz
- grid.411901.c0000 0001 2183 9102Department of Cell Biology, Physiology and Immunology, IMIBIC, Reina Sofía University Hospital, University of Córdoba, Cordoba, Spain
| | - María del Mar Malagón
- grid.411901.c0000 0001 2183 9102Department of Cell Biology, Physiology and Immunology, IMIBIC, Reina Sofía University Hospital, University of Córdoba, Cordoba, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Escudero-Contreras
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Chary López-Pedrera
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain
| | - Eduardo Collantes-Estévez
- grid.428865.50000 0004 0445 6160Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain ,grid.428865.50000 0004 0445 6160Medicine Department, University of Cordoba/IMIBIC/Reina Sofía University Hospital, Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Department, IMIBIC/Reina Sofía University Hospital/University of Cordoba, Cordoba, Spain. .,Medicine Department, University of Cordoba/IMIBIC/Reina Sofía University Hospital, Cordoba, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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5
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Pérez-Sánchez C, Cecchi I, Barbarroja N, Patiño-Trives AM, Luque-Tévar M, Pérez-Sánchez L, Ibáñez-Costa A, Arias de la Rosa I, Ortega R, Escudero A, Castro MC, Radin M, Roccatello D, Sciascia S, Aguirre MÁ, Collantes E, López-Pedrera C. Early restoration of immune and vascular phenotypes in systemic lupus erythematosus and rheumatoid arthritis patients after B cell depletion. J Cell Mol Med 2019; 23:6308-6318. [PMID: 31347786 PMCID: PMC6714224 DOI: 10.1111/jcmm.14517] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/06/2019] [Accepted: 06/04/2019] [Indexed: 12/22/2022] Open
Abstract
This translational multi‐centre study explored early changes in serologic variables following B lymphocyte depletion by rituximab (RTX) treatment in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients and investigated in vitro effects on the activity of other immune cells and the vascular endothelium. Eighty‐five SLE patients, seventy‐five RA patients and ninety healthy donors were enrolled. Two additional cohorts of selected SLE and RA patients were treated with RTX for 3 months. Changes in circulating levels of inflammatory mediators, oxidative stress markers and NETosis‐derived bioproducts were evaluated. Serum miRNomes were identified by next‐generation sequencing, and RTX‐induced changes were delineated. Mechanistic in vitro studies were performed to assess activity profiles. Altered inflammatory, oxidative and NETosis‐derived biomolecules were found in SLE and RA patients, closely interconnected and associated to specific miRNA profiles. RTX treatment reduced SLE and RA patients' disease activity, linked to a prominent alteration in those biomolecules and the reversal of altered regulating miRNAs. In vitro studies showed inhibition of NETosis and decline of pro‐inflammatory profiles of leucocytes and human umbilical vein endothelial cells (HUVECs) after B cell depletion. This study provides evidence supporting an early RTX‐induced re‐setting of the pro‐inflammatory status in SLE and RA, involving a re‐establishment of the homeostatic equilibrium in immune system and the vascular wall.
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Affiliation(s)
- Carlos Pérez-Sánchez
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Irene Cecchi
- Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Turin, Italy
| | - Nuria Barbarroja
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | | | - María Luque-Tévar
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Laura Pérez-Sánchez
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Iván Arias de la Rosa
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Rafaela Ortega
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - María Carmen Castro
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Massimo Radin
- Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Turin, Italy
| | - Dario Roccatello
- Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Turin, Italy
| | - Savino Sciascia
- Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Turin, Italy
| | - María Ángeles Aguirre
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Eduardo Collantes
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service, IMIBIC/Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
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6
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Ruiz-Limon P, Ortega-Castro R, Barbarroja N, Perez-Sanchez C, Jamin C, Patiño-Trives AM, Luque-Tevar M, Ibáñez-Costa A, Perez-Sanchez L, de la Rosa IA, Abalos-Aguilera M, Jimenez-Gomez Y, Calvo-Gutierrez J, Font P, Escudero-Contreras A, Alarcon-Riquelme ME, Collantes-Estevez E, López-Pedrera C. Molecular Characterization of Monocyte Subsets Reveals Specific and Distinctive Molecular Signatures Associated With Cardiovascular Disease in Rheumatoid Arthritis. Front Immunol 2019; 10:1111. [PMID: 31169830 PMCID: PMC6536567 DOI: 10.3389/fimmu.2019.01111] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/01/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives: This study, developed within the Innovative Medicines Initiative Joint Undertaking project PRECISESADS framework, aimed at functionally characterize the monocyte subsets in RA patients, and analyze their involvement in the increased CV risk associated with RA. Methods: The frequencies of monocyte subpopulations in the peripheral blood of 140 RA patients and 145 healthy donors (HDs) included in the PRECISESADS study were determined by flow cytometry. A second cohort of 50 RA patients and 30 HDs was included, of which CD14+ and CD16+ monocyte subpopulations were isolated using immuno-magnetic selection. Their transcriptomic profiles (mRNA and microRNA), proinflammatory patterns and activated pathways were evaluated and related to clinical features and CV risk. Mechanistic in vitro analyses were further performed. Results: CD14++CD16+ intermediate monocytes were extended in both cohorts of RA patients. Their increased frequency was associated with the positivity for autoantibodies, disease duration, inflammation, endothelial dysfunction and the presence of atheroma plaques, as well as with the CV risk score. CD14+ and CD16+ monocyte subsets showed distinctive and specific mRNA and microRNA profiles, along with specific intracellular signaling activation, indicating different functionalities. Moreover, that specific molecular profiles were interrelated and associated to atherosclerosis development and increased CV risk in RA patients. In vitro, RA serum promoted differentiation of CD14+CD16− to CD14++CD16+ monocytes. Co-culture with RA-isolated monocyte subsets induced differential activation of endothelial cells. Conclusions: Our overall data suggest that the generation of inflammatory monocytes is associated to the autoimmune/inflammatory response that mediates RA. These monocyte subsets, -which display specific and distinctive molecular signatures- might promote endothelial dysfunction and in turn, the progression of atherosclerosis through a finely regulated process driving CVD development in RA.
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Affiliation(s)
- Patricia Ruiz-Limon
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex (Virgen de la Victoria), Malaga, Spain
| | - Rafaela Ortega-Castro
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Perez-Sanchez
- Department of Medicine, School of Clinical Medicine, Addenbroke's Hospital, and Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Christophe Jamin
- U1227, Université de Brest, Inserm, Labex IGO, CHU de Brest, Brest, France
| | - Alejandra Maria Patiño-Trives
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Maria Luque-Tevar
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Laura Perez-Sanchez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Iván Arias de la Rosa
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - MaCarmen Abalos-Aguilera
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Yolanda Jimenez-Gomez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Jerusalem Calvo-Gutierrez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Pilar Font
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Marta E Alarcon-Riquelme
- Medical Genomics, Center for Genomics and Oncology Research: Pfizer, Andalusian Autonomous Government of Genomics and Oncological Research (GENYO), and University of Granada, Granada, Spain
| | - Eduardo Collantes-Estevez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
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