EULAR 2018 | Daily Highlights

B cell receptors predict clinical RA

DOMINANT B CELL RECEPTOR CLONES IN PERIPHERAL BLOOD PREDICT ONSET OF ARTHRITIS IN INDIVIDUALS AT RISK FOR RHEUMATOID ARTHRITIS – A VALIDATION COHORT

Abstract: OP0204
Authors: A. Musters et al.

» zum Abstract

Key content:
It is established that rheumatoid arthritis (RA) starts several years before the first signs of arthritis. It is widely believed that if we could treat patients during this pre-clinical phase of RA, curing RA would become a realistic goal. The main issue in treating RA in its pre-clinical phase is the adequate diagnosis of patients who are at very high risk of progressing to clinical RA.

This study tested the hypothesis that after the immune onset of the disease and during the pre-clinical phase of RA, specific clones of B-cells should be present in the circulation (i.e. “auto-reactive B-cell clones”). The authors observed indeed that the more dominant B-cell receptor clones (BCR) were found in individuals who developed arthritis within 3 years, compared to individuals who did not (p<0.0001). Over an average follow-up of 8 years, only 8% of the BCR-clone negative individuals developed arthritis compared to 76% of the BCR-clone positive individuals (RR 9.1 (95% CI 4.4-18.8)).

Relevance:
Dominant BCR clones in peripheral blood predict imminent onset of clinical symptoms of RA in seropositive arthralgia patients. BCR clones could help choosing the right individuals at high risk of RA, who are elligible for an early interventions to prevent onset of arthritis.

Zusammenfassung und Kommentar von:
Prof. Dr. Axel Finckh
Genf