Decreased circulating CD28-negative T cells in patients with rheumatoid arthritis treated with abatacept are correlated with clinical response.
OBJECTIVE
To verify the hypothesis that blockade of CD28 costimulation by treatment with abatacept in patients with rheumatoid arthritis (RA) might induce a reduction in the number of CD28- T cells, as well as other effector T cell populations. We evaluated whether these variations correlate with clinical response.


METHODS
Peripheral blood T cell subsets were longitudinally evaluated by flow cytometry through the analysis of CD28, CD45RA, and CCR7 expression in 16 patients with RA who were treated with abatacept.


RESULTS
After 48 weeks of treatment, the proportion and the absolute number of circulating CD8+CD28- T cells decreased (p = 0.008, p = 0.055, respectively, compared with baseline), as well as the proportion of the CD8+CD45RA+CCR7- cells, thought to represent terminally differentiated effector T cells (p = 0.03). Reductions of percentages of circulating CD4+CD28- and CD8+CD28- T cells, and (CCR7-) CD8+ total effector T cells were directly correlated with the reduction of Disease Activity Score 28 C-reactive protein (r = 0.58, p = 0.014; r = 0.47, p = 0.059; r = 0.59, p = 0.012, respectively).


CONCLUSIONS
After therapy with abatacept, circulating CD28- T cells and other effector populations decrease in patients with RA. This decrease is correlated with clinical response.
Rheumatology and Clinical Immunology Service, Spedali Civili and University of Brescia, Brescia, Italy.
Mirko
M
Scarsi
Tamara
T
Ziglioli
Paolo
P
Airò
D000069594:Abatacept; D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D002097:C-Reactive Protein / Q000276:immunology; D018106:CD28 Antigens / Q000276:immunology*; D002452:Cell Count; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D007156:Immunologic Memory / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D018106:CD28 Antigens; D018796:Immunoconjugates; D000069594:Abatacept; D002097:C-Reactive Protein