title: Higher percentage of CD3⁺CD154⁺ T lymphocytes predicts efficacy of TNF-α inhibitors in active axial SpA patients.
abstract: The objective of this study was to evaluate which subtypes of T lymphocytes (CD3(+)CD28(+) and CD3(+)CD154(+)) could predict clinical efficacy after TNF-α inhibitor treatment in active axial SpA patients. Patients who fulfilled Assessment of SpondyloArthritis international Society (ASAS) criteria for axial SpA had a BASDAI of ≥40 mm. All patients received TNF-α inhibitor treatment for 12 weeks. ASAS20 was used to evaluate the effect of the treatment at week 12. We detected the percentage of CD3(+)CD28(+) and CD3(+)CD154(+) T lymphocytes on lymphocyte cells in the peripheral blood in patients and healthy controls. We evaluated whether the percentage of the above subtypes of T lymphocytes could predict clinical efficacy by ROC curve analysis. Fifty-eight healthy controls and 74 active axial SpA patients were included. Mean age was 26.28 ± 9.08 and 26.95 ± 8.13 years for healthy controls and patients, respectively (p = 0.767). The percentage of CD3(+)CD154(+) T lymphocytes was significantly higher in axial SpA patients than in healthy controls (1.62 ± 1.89 % vs 0.79 ± 0.52 %, p < 0.0005). At baseline, the percentage of CD3(+)CD154(+) T lymphocytes was significantly higher in HLA-B27((+)) patients than HLA-B27((-)) ones (HLA-B27(+) vs HLA-B27(-):1.77 ± 1.95 % vs 0.41 ± 0.27 %, p = 0.005). Compared with baseline, the percentage of CD3(+)CD154(+) T lymphocytes significantly decreased to 0.87 ± 0.49 % at week 12 (p < 0.0005). Moreover, we found higher percentage of CD3(+)CD154(+) T lymphocytes could predict clinical efficacy of SpA patients with TNF-α inhibitor treatment (AUC = 0.733, p = 0.014). High percentage of CD3(+)CD154(+) is over-expressed on lymphocytes in peripheral blood of active SpA patients and can be down-regulated by TNF-α inhibitor therapy. High-percentage of CD3(+)CD154(+) T lymphocytes may predict clinical efficacy of TNF-α inhibitor treatment in active axial SpA patients.
authors.affiliation: Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People's Republic of China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Lin
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.forename: Zetao
authors.initials: Z
authors.lastname: Liao
authors.forename: Qiuxia
authors.initials: Q
authors.lastname: Li
authors.forename: Fucheng
authors.initials: F
authors.lastname: Zhang
authors.forename: Qiujing
authors.initials: Q
authors.lastname: Wei
authors.forename: Shuangyan
authors.initials: S
authors.lastname: Cao
authors.forename: Jieruo
authors.initials: J
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017252:CD3 Complex / Q000097:blood*; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D006801:Humans; D000069285:Infliximab; D007279:Injections, Subcutaneous; D008297:Male; D011237:Predictive Value of Tests; D025241:Spondylarthritis / Q000097:blood* / Q000188:drug therapy; D013601:T-Lymphocytes / Q000187:drug effects / Q000378:metabolism*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D017252:CD3 Complex; D014409:Tumor Necrosis Factor-alpha; D023201:CD40 Ligand; D000069285:Infliximab