title: The number of circulating monocytes as biomarkers of the clinical response to methotrexate in untreated patients with rheumatoid arthritis.
abstract: BACKGROUND
  The aim of this work was to analyze the number and distribution of circulating monocytes, and of their CD14(+high)CD16(-), CD14(+high)CD16(+) and CD14(+low)CD16(+) subset cells, in treatment-naive patients with rheumatoid arthritis (RA), and to determine their value in predicting the clinical response to methotrexate (MTX) treatment.
  
  
  METHODS
  This prospective work investigated the number of circulating monocytes, and the numbers of CD14(+high)CD16(-), CD14(+high)CD16(+) and CD14(+low)CD16(+) subset cells, in 52 untreated patients with RA before MTX treatment, and at 3 and 6 months into treatment, using flow cytometry.
  
  
  RESULTS
  The absolute number of circulating monocytes, and the numbers of CD14(+high)CD16(-), CD14(+high)CD16(+) and CD14(+low)CD16(+) subset cells, were significantly higher in MTX non-responders than in responders and healthy controls before starting and throughout treatment. Responders showed normal numbers of monocytes, and of their subset cells, over the study period. The pre-treatment absolute number of circulating monocytes, and the numbers of CD14(+high)CD16(-) and CD14(+high)CD16(+) subset cells, were found to be predictive of the clinical response to MTX, with a sensitivity and specificity of >70% and >88%, respectively.
  
  
  CONCLUSIONS
  Treatment-naive patients with RA showed an anomalous distribution of circulating monocyte subsets, and an anomalous number of cells in each subset. A higher pre-treatment number of circulating monocytes, and higher numbers of CD14(+high)CD16(-) and CD14(+high)CD16(+) subset cells, predict a reduced clinical response to MTX in untreated patients with RA.
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. lucho_chara@yahoo.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Chara
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. aisatrio@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Atrio
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. aperezalcala@yahoo.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Pérez
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. ecuende@gmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cuende
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. fernando.albarran@uah.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Albarrán
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. anaturrion@hotmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Turrión
authors.affiliation: Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. juliochevarria@yahoo.com.
authors.forename: Julio
authors.initials: J
authors.lastname: Chevarria
authors.affiliation: Department of Health and Medical Social Sciences, University of Alcalá, Madrid, Spain. angel.asunsolo@uah.es.
authors.forename: Angel Asunsolo
authors.initials: AA
authors.lastname: del Barco
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. smimasl@hotmail.com.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sánchez
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. jorge.monserrat@uah.es.
authors.forename: Jorge
authors.initials: J
authors.lastname: Monserrat
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. alfredo.prieto@uah.es.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Prieto
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. antonio.delahera@uah.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: de la Hera
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Medicine, Emory University, Atlanta, GA, USA. ignacio.sanz@emory.edu.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sanz
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. david.diaz@uah.es.
authors.forename: David
authors.initials: D
authors.lastname: Diaz
authors.affiliation: Department of Medicine, University of Alcalá, Carretera Madrid-Barcelona km 33.600, 28871, Alcalá de Henares, Madrid, Spain. mademons@gmail.com.|Immune System Diseases-Rheumatology and Oncology Service, University Hospital "Príncipe de Asturias", Alcalá de Henares, Madrid, Spain. mademons@gmail.com.
authors.forename: Melchor
authors.initials: M
authors.lastname: Alvarez-Mon
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology*; D015415:Biomarkers / Q000378:metabolism*; D000073883:CX3C Chemokine Receptor 1; D016022:Case-Control Studies; D002452:Cell Count; D002465:Cell Movement; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D012372:ROC Curve; D019707:Receptors, Chemokine / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D000073883:CX3C Chemokine Receptor 1; C095235:CX3CR1 protein, human; D019707:Receptors, Chemokine; D008727:Methotrexate