BackgroundRemission is arguably the ultimate therapeutic goal in rheumatoid arthritis (RA). Applying modern strategies, clinical remission can be achieved in a substantial number of patients with early RA (ERA). Even in those patients, the number and scope of erosions can increase. We, therefore, investigated the value of MRI for the detection of radiological progression in patients with DAS28 improvement and/or clinical remission of the German Remission-plus cohort.MethodsData-sets of 80 RA patients (according to 2010 ACR/EULAR criteria) from the Remission-plus study cohort, who fulfilled the following criteria, were retrospectively analysed: availability of two consecutive MRI scans (low-field MRI, follow-up interval 1 year) of the clinically dominant hand and wrist, and the presence of DAS28 (CRP) scores at both time points, which was used to assess disease activity.ResultsSeventy-one of the 80 investigated patients presented a numerical improvement of the DAS28 (CRP) after 12 months (DAS28(CRP) T0 average (Ø) 4.96, SD 1.2; DAS28 T4 (12 month) Ø 2.6, SD 1.0), 73% of them also improved in the RAMRIS-Score, while 24% demonstrated an increase despite DAS28 improvement and 3% showed equal values. 48% of patients who improved in the DAS28 reached EULAR remission. 41% of these patients had an increase in the RAMRIS Erosion-subscore after 12 months. When considering EULAR response criteria (non-response (n = 7), moderate response (n = 19), good response (n = 45)), an increase of erosions was found in 71.4% of non-responders, 52.6% of moderate responders, and 31.1% of good responders after 12 months, all compared to baseline.ConclusionUp to 40% of patients in this study demonstrated a progressive erosive disease detected by MRI despite DAS28 improvement or EULAR remission. Future studies are needed to determine the prognostic clinical impact of disease progression in MRI despite clinical remission, and to investigate if DAS28 remission may be an insufficient therapeutic goal and should be accompanied by MRI remission criteria.
tive expression 12,57 in HT vs. 19.40 in control group (CG), p = 0.0002; 12,10 in GD vs. 19.40 in CG, p = 0.0002) and in CD8 + -T-cells (13.13 in HT vs. 18,12 in CG, p = 0.02; 11.66 in GD vs. 18.12 in CG, p = 0.0002). GD and HT showed signifi cantly decreased miRNA 155_2 and miRNA 155*_1 in HT in CD8 + -T-cells (10.69 in HT vs. 11.30 in CG, p = 0.01; 10.40 in GD vs. 11.30 in CG, p = 0.005). This study confi rms signifi cant variations of miRNA200a and miRNA155 in patients suffering from GD and HT in vivo in CD4 + T-cells and CD8 + T-cells. These data may help to better understand the gene regulations in the causative cells causing these autoimmune processes. They extend our very limited knowledge concerning miRNAs in thyroid diseases.
Abstract
▼Graves' disease (GD) and Hashimoto's thyroiditis (HT) are the most common autoimmune thyroid diseases (AITD). MicroRNAs (miRNAs) critically control gene-expression and play an important role in regulating the immune response. The aim of this study was to prove signifi cant variations of key immunoregulatory miRNAs in peripheral blood mononuclear cells (PBMCs) and in CD4 + and CD 8 + T-cells of AITD patients. Selected miRNAs were amplifi ed by a semiquantitative SYBR Green PCR from PBMCs and purifi ed CD4 + and CD 8 + T-cells of 59 patients with GD, HT, and healthy controls. Both GD and HT showed signifi cantly decreased miRNA 200a_1 and miRNA 200a2* in CD4 + -T-cells (mean rela-
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