Association of anticytomegalovirus seropositivity with more severe joint destruction and more frequent joint surgery in rheumatoid arthritis

Abstract

Objective. Expansion of autoreactive CD4؉ CD28null T cells is associated with extraarticular disease manifestations, including rheumatoid vasculitis, and it has recently been demonstrated that expansion of these T cells is associated with anticytomegalovirus (anti-CMV) seropositivity. This study was undertaken to investigate a possible link between latent CMV infection and rheumatoid arthritis (RA).Methods. In a retrospective analysis, anti-CMV antibodies and clinical, serologic, and radiologic parameters of joint destruction were examined in 202 RA patients and 272 healthy controls. In addition, frequencies of CD4؉CD28 null T cells; concentrations of the cytokines monocyte chemotactic protein 1 (MCP-1), interferon-␣ (IFN␣), and IFN-inducible protein 10; and anti-CMV-specific T cell responses were analyzed in RA patients.Results. Overall, no significant difference in the frequency of anti-CMV seropositivity between RA patients and healthy controls was observed. Among individuals older than age 55 years, however, anti-CMV IgG antibodies were significantly more frequent in RA patients than controls (65.3% and 54.7%, respectively; P ‫؍‬ 0.05). Anti-CMV seropositivity in RA patients was associated with an increased frequency of CD4؉CD28

Immunosenescence: Implications for response to infection and vaccination in older people

“…Therefore, CMV infection may result in increased risk of autoantibody production, which could precede the onset of autoimmune disease. A recent study has reported that in CMV-infected RA patients joint destruction is more severe than in CMV-uninfected RA [64]. Chronic persistent pathogens, like CMV, are frequently reactivated in human autoimmune disease and can target the site of autoimmune inflammation [65].…”

How does cytomegalovirus factor into diseases of aging and vaccine responses, and by what mechanisms?

“…Rheumatoid arthritis Latent CMV infection influences the clinical course and outcome of rheumatoid arthritis (RA) (Davis et al 2012;Pierer et al 2012), and CMV has been associated with more severe joint disease in patients with RA (Rothe et al 2016). Specific immunopathogenic mechanisms through which CMV could contribute to aggravation of joint damage in RA patients include the expansion of CMV-specific CD4+ CD28− (Pawlik et al 2003) and CD8+CD28− (Rothe et al 2016) T cells, which directly contribute to tissue lesions.…”

Human Cytomegalovirus and Autoimmune Disease

“…Only few studies were found that have determined HCMV seroprevalence in RA patients: whereas higher HCMV coincidence with RA was found in one report [91], the two others did not observe this [83, 100]. All studies were carried out in Europe.…”