Plasma cells as a marker
predicting the outcome of anti-TNF therapy
Růžičková Š.1, 3, Cimburek Z.2, Jarošová K.1, Forejtová Š.1, Vencovský J.1
1Revmatologický ústav, Praha, 2Sektor imunologie a gnotobiologie, Mikrobiologický ústav AV ČR, Praha, 3Biotechnologický sektor, Ústav molekulární genetiky AV ČR, Praha |
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Summary:
The aim of the study was to identify cell population which could be used as a marker predicting response
to anti-TNF therapy. A total of 46 patients was analyzed, out of them: 23 patients with juvenile idiopatic
arthritis (11 – Enbrel, 11– Remicade and 1– Humira), 16 patients with ankylosing spondylitis (8 – Enbrel,
8 – Remicade), 5 patients with rheumatoid arthritis (all Enbrel) and 2 patients with psoriatic arthritis
(both Enbrel) and 19 controls. Clinical parameters (CRP, ESR, DAS28, BASDAI, VAS score, number of
tender and swollen joints) from 11 patients with juvenile idiopatic arthritis and 3 with ankylosing spondylitis
were available before and 3 months after onset of the therapy. Immunophenotyping of peripheral
blood of patients and controls was performed using polychromatic flow cytometry. A population of
CD19+CD20-CD27highCD38+CD138+ plasma cells was identified which significantly differed in the frequencies
between responding and resistent patients (responders: 1.3–10.3%; median 7.04±1.05; 95%CI
4.06–9.03 vs. non-responders 17.3–37.3; median 27.75±9.18; 95%CI 18.12–37.38; p=0.0007). All responders showed
statistically significant improvement of clinical parameters. The frequency of CD19+CD20-CD27highCD38+
CD138+ plasma cell population was found to be in responders at least 13-fold reduced in comparison
to non-responders and this population might represent biological marker predicting the outcome of
anti-TNF therapy
Key words:
anti-TNF, B-cells, plasma cells, flow cytometry, response to therapy
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