Ectopic lymphoid structures support ongoing production of class-switched autoantibodies in rheumatoid synovium
2009

Ectopic Lymphoid Structures in Rheumatoid Arthritis Support Autoantibody Production

Sample size: 55 publication Evidence: high

Author Information

Author(s): Frances Humby, Michele Bombardieri, Antonio Manzo, Stephen Kelly, Mark C. Blades, Bruce Kirkham, Jo Spencer, Costantino Pitzalis

Primary Institution: William Harvey Research Institute, Barts and the London School of Medicine, London, United Kingdom

Hypothesis

Do ectopic lymphoid structures in rheumatoid arthritis synovium support the production of autoantibodies?

Conclusion

Ectopic lymphoid structures in the rheumatoid synovium are functional and support the ongoing production of autoantibodies.

Supporting Evidence

  • All FDC-containing structures in the study expressed AID.
  • AID expression was associated with the presence of ACPA-producing plasma cells.
  • Transplanted RA synovial tissue maintained AID expression and produced human IgG ACPA in mice.
  • High levels of AID correlated with higher levels of ACPA in mouse serum.

Takeaway

In rheumatoid arthritis, certain structures in the joint help make harmful antibodies that attack the body, even when they are removed and placed in mice.

Methodology

The study used immunohistochemistry and quantitative Taqman real-time PCR to analyze synovial tissue from patients with rheumatoid arthritis.

Limitations

The study cannot exclude the possibility that pre-existing long-lived plasma cells contribute to autoantibody production.

Participant Demographics

Patients with rheumatoid arthritis undergoing joint surgery.

Statistical Information

P-Value

p<0.0002

Statistical Significance

p<0.0002

Digital Object Identifier (DOI)

10.1371/journal.pmed.0060001

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