What is it about?
Despite displaying clinical inactivity during treatment, many juvenile idiopathic arthritic (JIA) patients will flare upon cessation of therapy (TNFi). The inability to definitively discriminate patients who will relapse or continue to remain in remission after therapy withdrawal is currently a major unmet medical need. In this study we explored the CD4 circulatory immune landscape of JIA patients prior to therapy withdrawal with the high dimensional single cell platform, CyToF. We discovered a subset of CD4 inflammatory memory subset deficient in immune checkpoints (CD3+CD4+CD45RA-TNFa+PD1-CD152-) that is present in patients prior to relapse. Cross comparisons with healthy individuals further reveal a subclinical subset that is indicative of T effector diversification (IL-6+), whose presence is further confirmed in patients during overt flare manifestation. Pathway analysis of immune genes with Nanostring reveal divergence in common disease centric pathways in relapse versus remission patients. We believe this study brings us a step closer to understanding disease mechanisms involved in relapse or stable remission, and hopefully help define better strategies for therapy withdrawal in JIA patients.
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This page is a summary of: Immunome perturbation is present in patients with juvenile idiopathic arthritis who are in remission and will relapse upon anti-TNFα withdrawal, Annals of the Rheumatic Diseases, September 2019, BMJ,
DOI: 10.1136/annrheumdis-2019-216059.
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