Six-month prospective trial in early and long-standing rheumatoid arthritis: evaluating disease activity in the wrist through sequential synovial histopathological analysis, RAMRIS magnetic resonance score and EULAR-OMERACT ultrasound score

Just, Søren Andreas; Nielsen, Christian; Werlinrud, Jens Christian; Larsen, Pia Veldt; Klinkby, Camilla Schufri; Humby, F; Torfing, Trine; Lindegaard, Hanne

doi:10.1136/rmdopen-2019-000951

Cited by 17 publications

(12 citation statements)

References 29 publications

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“…Next, we investigated which types of specific lipids best represent synovitis severity, as determined by ultrasonography (which reflects histological synovitis) 27 , 28 . The severity of synovitis was assessed by ultrasonography at the time of SF aspiration.…”

Section: Resultsmentioning

confidence: 99%

Lipidome profile predictive of disease evolution and activity in rheumatoid arthritis

et al. 2022

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Lipid mediators are crucial for the pathogenesis of rheumatoid arthritis (RA); however, global analyses have not been undertaken to systematically define the lipidome underlying the dynamics of disease evolution, activation, and resolution. Here, we performed untargeted lipidomics analysis of synovial fluid and serum from RA patients at different disease activities and clinical phases (preclinical phase to active phase to sustained remission). We found that the lipidome profile in RA joint fluid was severely perturbed and that this correlated with the extent of inflammation and severity of synovitis on ultrasonography. The serum lipidome profile of active RA, albeit less prominent than the synovial lipidome, was also distinguishable from that of RA in the sustained remission phase and from that of noninflammatory osteoarthritis. Of note, the serum lipidome profile at the preclinical phase of RA closely mimicked that of active RA. Specifically, alterations in a set of lysophosphatidylcholine, phosphatidylcholine, ether-linked phosphatidylethanolamine, and sphingomyelin subclasses correlated with RA activity, reflecting treatment responses to anti-rheumatic drugs when monitored serially. Collectively, these results suggest that analysis of lipidome profiles is useful for identifying biomarker candidates that predict the evolution of preclinical to definitive RA and could facilitate the assessment of disease activity and treatment outcomes.

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Section: Resultsmentioning

confidence: 99%

Lipidome profile predictive of disease evolution and activity in rheumatoid arthritis

et al. 2022

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“…Data from this cohort comparing wrist synovial biopsy inflammation with disease activity in the wrist by X-ray, ultrasound and MRI have been published separately. 20 Overlapping results are a description of ultrasound and MRI data, synovial inflammation and RA disease activity. In this article, we use the Larsen score for all joints of the biopsied hand and not only the biopsied wrist.…”

Section: Methodsmentioning

confidence: 99%

“…29 On the same side as the USGSB procedure was to be performed, an MRI of the hand and wrist was performed, as previously described. 20 MRI was performed for a maximum of 2 hours before the biopsy procedure for all at baseline and also at 6 months for ERA. Using the RAMRIS system, a consultant in radiology (TT) scored all examinations.…”

Section: Methodsmentioning

confidence: 99%

Fibrocytes in early and long-standing rheumatoid arthritis: a 6-month trial with repeated synovial biopsy, imaging and lung function test

Just¹,

Nielsen

Werlinrud

et al. 2021

RMD Open

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ObjectivesTo correlate the level of fibrocytes in peripheral blood, synovial tissue and in vitro culture in rheumatoid arthritis (RA) with changes in disease activity, imaging and pulmonary function.MethodsTwenty patients with early RA (ERA) and 20 patients with long-standing RA (LRA) were enrolled in a 6-month prospective study. Sixteen patients undergoing wrist arthroscopy were healthy controls. Patients with RA underwent pulmonary function tests, ultrasound and synovial ultrasound-guided needle biopsy of the same wrist at baseline and 6 months. Wrist MRI was performed at baseline (all) and 6 months (ERA). Circulating fibrocytes were measured by flow cytometry, in vitro by the number of monocytes that were differentiated to fibrocytes and in synovial biopsies by counting in histological sections.ResultsFibrocytes were primarily located around vessels and in the subintimal area in the synovium. Fibrocyte levels did not decline during the trial despite effective RA treatment. In the ERA group, increased synovitis assessed by ultrasound was moderate and strongly correlated with an increase in circulating and synovial fibrocyte levels, respectively. Increased synovitis assessed by MRI during the trial in the ERA group was moderately correlated with both increased numbers of circulating and cultured fibrocytes. Absolute diffusion capacity level was overall weakly negatively correlated with the level of circulating and synovial fibrocytes. The decline in diffusion capacity during the trial was moderately correlated with increased levels of synovial fibrocytes.ConclusionOur findings suggest that fibrocytes are involved in RA pathogenesis, both in the synovium and the reduction in lung function seen in a part of patients with RA.Trial registration numberNCT02652299.

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“…They found that EULAR-OMERACT ultrasound score and RAMRIS MRI score were strongly correlated with Krenn's synovitis score at baseline, but not 6-month assessment, in the early RA group. In the established RA group, a moderate to strong correlation was present between the three scores at baseline assessment, except for the RAMRIS 6-month assessment, which was not performed (53).…”

Section: Quality and Quantity Of Synovial Samples Collected By Usgsbmentioning

confidence: 89%

Ultrasound-Guided Synovial Biopsy: A Review

Saraiva

2021

Front. Med.

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Ultrasound-guided synovial biopsy is a safe, well-tolerated, and effective method to collect good-quality synovial tissue from all types of joints for clinical and research purposes. Although synovial biopsy cannot be used to distinguish between types of inflammatory rheumatic disease, analysis of synovial tissue has led to remarkable advances in the understanding of the pathobiology of rheumatoid arthritis and other inflammatory rheumatic diseases. Synovitis is the hallmark of these diseases; hence, accessing the core of the pathological process, synovial tissue, provides an opportunity to gather information with potential diagnostic and prognostic utility.

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Six-month prospective trial in early and long-standing rheumatoid arthritis: evaluating disease activity in the wrist through sequential synovial histopathological analysis, RAMRIS magnetic resonance score and EULAR-OMERACT ultrasound score

Cited by 17 publications

References 29 publications

Lipidome profile predictive of disease evolution and activity in rheumatoid arthritis

Lipidome profile predictive of disease evolution and activity in rheumatoid arthritis

Fibrocytes in early and long-standing rheumatoid arthritis: a 6-month trial with repeated synovial biopsy, imaging and lung function test

Ultrasound-Guided Synovial Biopsy: A Review

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