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Abberancies of specific peripheral blood t-cell and monocyte subpopulations in ankylosing spondilitis correlate with disease activity parameters

Background: Autoimmunity is major driving force in pathogenesis of rheumatic diseases, including ankylosing spondylitis (AS). AS is associated with abnormal immune cell functions. Several recent studies stressed the role of T- cells and monocyte subpopulations in AS, but these mechanisms are signifi cantly less understood compared to other rheumatic diseases (1). Objectives: Th e aim was to compare the frequency of T-cell and monocyte subpopulations in AS patients and controls, and to correlate them with disease activity. Methods: Mononuclear cells (MNC) were isolated from blood of healthy controls (n=110) and AS (n=65) patients. T-cell and monocyte phenotype of MNC was determined using fl ow cytometry for the following markers: Th 1/2 (CD3+CD4+CCR6–), Th 17 (CD3+CD4+CCR4+CCR6+), Tfh (CD3+CD4+CXCR5+), Tc (CD3+CD8+), memory Tc (CD3+CD8+CCR4+) double- positive (dp) Tc (CD3+CD4+CD8+) ; and monocytes (CD3-CD19-CD56-CD11b+CD14+). On lymphocytes IL21R, CD25 and CD11b were analyzed ; while on monocytes chemokine receptors CCR1, CCR2, CCR4, CXCR4 and RANK. Frequencies of lymphocyte and monocyte subpopulations were correlated with ASDAS, BASDAI, VAS of pain in spine and peripheral joints, stiff ness intensity and duration, ESR and CRP. Results: Results showed decrease of memory Tc (p=0.022) and Tfh in AS (p=0.038) which correlated negatively with physician’s assessment of disease activity. Th e frequency of dp Tc was unchanged, but negatively correlated with BASDAI and pain assessment. Th e frequency of monocytes was decreased in AS (p<0.001), while the subpopulation expressing RANK was increased (p=0.007). In monocytes ; CCR1 correlated with BASDAI and pain assessment, CCR2 correlated with stiff ness duration. CXCR4 expression was increased in AS (p<0.001) and correlated with BASDAI and stiff ness intensity. Conclusions: Results show changes in T-cells and monocyte subpopulations induced in AS and indicate their possible importance for AS pathogenesis. Peripheral blood dp Tc cells may be of particular interest as further research targets for novel therapeutic approaches, since their frequency is associated with disease activity and patient’s pain assessment (2).

ankylosing spondylitis ; T-cell ; monocyte ; disease acitvity ; flow cytometry

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