AB0038 CIRCULATING MICRORNAS IN HAND OSTEOARTHRITIS

Background:

microRNAs (miRNAs) are small non-coding RNAs that can ignite the degradation of mRNAs or inhibit the protein translation and are therefore essential for several physiological and pathological functions. miRNAs can regulate up to 60 % of human mRNA, including genes related to cartilage development, homeostasis, and OA pathology. For example, miR-9 inhibits matrix metalloproteinase 13 or miR-140 expression level correlates with the disease progression of knee OA (Zhang et al.; Chao et al.). Under certain circumstances, miRNAs can be released into the body fluids and easily be detected in the blood samples. Therefore, miRNAs are hot candidates as biomarkers for early diagnosis or structural progression of OA.

Objectives:

The aim of this study was to evaluate circulating miRNAs in patients with hand osteoarthritis (HOA) and healthy individuals. Simultaneously, we studied specific miRNAs in order to differentiate between erosive and non-erosive subsets of the disease.

Methods:

Eight patients with HOA (erosive: n=4, 3 females, mean age=63.7±7 yrs; non-erosive: n=4, 3 females, mean age= 62.4±6 yrs) and 4 healthy controls (3 females, mean age=63.5±7 yrs) were included in this study. Firstly, Advance TaqMan low-density assay (TLDA) was performed for the purpose of miRNA high-throughput screening. Differently expressed miRNAs were further verified by real-time qPCR on the validation cohort in 31 patients with hand OA (19 females, mean age=66.2±7 yrs, erosive: n=9, non-erosive: n=10, healthy controls: n=12).

Results:

TLDA profiling displayed 346 circulating miRNAs in plasma of patients with HOA and healthy controls. We demonstrated 40 differently expressed circulating miRNAs in patients with HOA compared with healthy controls. Using a real-time qPCR, we verified increased expression levels of 10 circulating miRNAs in patients with HOA compared with healthy controls, e.g. miR-191-5p (3.4 fold), miR-151a-3p (3.4 fold) or miR-222-3p (2.4 fold). We did not find any specific miRNA, which could distinct erosive from a non-erosive subset of the disease.

Conclusion:

Extensive profiling of circulating miRNAs revealed several miRNAs that can be associated with HOA and can help to better understand OA pathogenesis.

References:

[1]Chao, Yu, et al. “Expression of MiR-140 and MiR-199 in Synovia and Its Correlation with the Progression of Knee Osteoarthritis.” Medical Science Monitor, vol. 26, 2020, pp. 1–6, doi:10.12659/MSM.918174.

[2]Zhang, Hongxin, et al. “Downregulation of MicroRNA-9 Increases Matrix Metalloproteinase-13 Expression Levels and Facilitates Osteoarthritis Onset.” Molecular Medicine Reports, vol. 17, no. 3, 2018, pp. 3708–14, doi:10.3892/mmr.2017.8340.

Acknowledgements:

Supported by AZV NV18-01-00542, MHCR No. 023728

Disclosure of Interests:

None declared

SAT0477 A TWO-YEAR LONGITUDINAL STUDY COMPLETION, LONGITUNEAL STUDY, THE DIFFERENCE IN BONE LOSS IN PATIENTS WITH EROSIVE AND NON-EROSIVE HAND OSTEOARTHRITIS

Background:

Hand osteoarthritis (OA) and its more severe subset erosive hand OA are common causes of pain and morbidity. Some metabolic factors were suggested to be implicated in erosive disease. Few studies investigated differences in systemic bone loss between erosive and non-erosive hand OA.

Objectives:

To compare the change of bone mineral density (BMD) between patients with erosive and non-erosive hand OA in a two-year longitudinal study.

Methods:

Consecutive patients with symptomatic HOA fulfilling the American College of Rheumatology (ACR) criteria were included in this study. Erosive hand OA was defined by at least one erosive interphalangeal joint. All patients underwent clinical assessments of joint swelling and radiographs of both hands. DEXA examination of lumbar spine, total femur and femur neck was performed at the baseline and after two years.

Results:

Altogether, 141patients (15 male) with symptomatic nodal HOA were included in this study and followed between April 2012 and January 2019. Out of these patients, 80 had erosive disease after two years. The disease duration (p<0.01) was significantly higher in patients with erosive compared with non-erosive disease at baseline.

Osteoporosis (T-score <-2.5 SD) was diagnosed in 12.5% (9/72) of patients with erosive hand OA and in 8.06% (5/57) of patients with non-erosive hand OA at baseline. BMD was significantly lowered in patients with erosive compared with non-erosive disease at baseline (lumbar spine: 1.05g/cm2 vs. 1.13 g/cm2, p<0.05, total femur: 0.90 g/cm2 vs. 0.97 g/cm2, p<0.01 and femur neck: 0.86 g/cm2 vs. 0.91, p<0.05). T-scores of lumbar spine (-0.96 vs. -0.41 SD, p<0.05), total femur (-0.69 vs. -0.33 SD, p<0.05) and femur neck (-1.14 vs. -0.88 SD, p<0.05) were also significantly lowered in patients with erosive compared with non-erosive disease.

Two years, the BMD remained also significantly lowered in patients with erosive compared with non-erosive disease (lumbar spine: 1.05g/cm2 vs. 1.14 g/cm2, p<0.05, total femur: 0.92 g/cm2 vs. 0.97 g/cm2, p<0.05 and femur neck: 0.86 g/cm2 vs. 0.91, p<0.05), which was in agreement with the finding for T-scores of lumbar spine (-1.05 vs. -0.39 SD, p<0.05), total femur (-0.74 vs. -0.34 SD, p<0.01) and femur neck (-1.07 vs. -0.72 SD, p<0.01).

Conclusion:

These results suggest that patients with erosive hand OA are at higher risk for the development of general bone loss. Over two years patients with erosive disease had significant lower bone mineral density at all measured sites.

References:

[1]This work was supported by the project AZV no. 18-00542 and MHCR No. 023728.

Acknowledgments:

Project AZV no. 18-00542 and MHCR No. 023728

Disclosure of Interests:

Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Olga Sleglova: None declared, Jiří Baloun: None declared, Olga Růžičková: None declared

FRI0255 BODY COMPOSITION IN SCLERODERMA PATIENTS IS ASSOCIATED WITH DISEASE ACTIVITY, SERUM LEVELS OF INFLAMMATORY CYTOKINES AND PARAMETERS OF NUTRITION AND LIPID METABOLISM

Background:

Fibrosis of the skin and visceral organs, especially digestive tract, and musculoskeletal involvement in systemic sclerosis (SSc) can have a negative impact on body composition, physical activity and nutritional status.

Objectives:

The aim was to assess body composition and physical activity of SSc patients and healthy controls (HC) and the association with selected inflammatory cytokines/chemokines and laboratory markers of nutritional status and lipid metabolism in SSc.

Methods:

59 patients with SSc (50 females; mean age 52.5; disease duration 6.7 years; lcSSc: 34/dcSSc: 25) and 59 age-/sex-matched HC (50 females, mean age 52.5) without rheumatic or tumour diseases were included. SSc patients fulfilled ACR/EULAR 2013 criteria. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA-2000-M), physical activity (Human Activity Profile, HAP questionnaire), disease activity (ESSG activity index), serum levels of 27 cytokines/chemokines (commercial multiplex ELISA kit, Bio-Rad Laboratories) and serum levels of chosen parameters of nutrition and lipidogram. Data are presented as mean±SD.

Results:

Compared to HC, patients with SSc had significantly lower body mass index (BMI, 27.4±8.3 vs. 22.4±4.3 kg/m2, p<0,001), body fat % (BF%, iDXA: 38.0±7.6 vs. 32.6±8.2 kg, p<0,001; BIA: 31.3±7.6 vs. 24.3±7.9 kg, p<0,001) and visceral fat weight (VF, 1.0±0.8 vs. 0.5±0.5 kg, p=0,001), and also significantly decreased lean body mass (LBM, iDXA: 51.9±8.4 vs. 47.8±7.0 kg, p=0,005; BIA: 45.4±7.3 vs. 40.9±6.8 kg, p=0,005), and bone mineral density (BMD, 1.2±0.1 vs. 1.0±0.1 g/cm2, p<0,001). Compared to HC, patients with SSc had increased extracellular mass/body cell mass (ECM/BCM, 1.03±0.1 vs. 1.28±0.4, p<0,001) ratio, reflecting deteriorated nutritional status and worse muscle predispositions for physical activity. Increased ECM/BCM in SSc was associated with higher disease activity (ESSG), increased skin score (mRSS) and inflammation (CRP, ESR), and with worse quality of life (HAQ, SHAQ), fatigue (FSS), and decreased physical activity (HAP). ESSG negatively correlated with BF%. HAP positively correlated with BMD. Serum levels of several inflammatory cytokines/chemokines (specifically IL-1b, IL-5, IL-6, IL-8, IL-17, TNF, Eotaxin) and markers of nutrition (specifically total protein, albumin, insulin and C-peptide) and lipid metabolism (specifically triglycerides, high-density lipoprotein, apolipoprotein A, atherogenic index of plasma) were significantly associated with alterations of body composition in patients with SSc (p<0.05 for all correlations).

Conclusion:

Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our SSc patients, which are associated with the disease activity and physical activity, and could reflect their nutritional status, and gastrointestinal and musculoskeletal involvement. Detected alterations of body composition in SSc patients were significantly associated with serum levels of several inflammatory cytokines/chemokines and markers of nutrition and lipid metabolism, which might further support the role of systemic inflammation and nutritional status on the negative changes in body composition of SSc patients

Acknowledgments:

Supported by AZV NV18-01-00161A, MHCR 023728, SVV 260373 and GAUK 312218

Disclosure of Interests:

Sabina Oreska: None declared, Maja Špiritović: None declared, Petr Česák: None declared, Michal Cesak: None declared, Hana Štorkánová: None declared, Hana Smucrova: None declared, Barbora Heřmánková: None declared, Olga Růžičková: None declared, Heřman Mann: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Jiří Vencovský: None declared, Radim Bečvář Consultant of: Actelion, Roche, Michal Tomčík: None declared

THU0358 NEGATIVE CHANGES OF BODY COMPOSITION IN MYOSITIS PATIENTS AND THEIR ASSOCIATION WITH DISEASE SPECIFIC CHARACTERISTICS, PHYSICAL ACTIVITY AND NUTRITIONAL STATUS

Background:

Skeletal muscle, pulmonary and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition.

Objectives:

The aim was to assess body composition and physical activity of IIM patients and healthy controls (HC) and the association with selected inflammatory cytokines/chemokines and laboratory markers of nutrition and lipid metabolism.

Methods:

54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; polymyositis (PM, 22) / dermatomyositis (DM, 25) / necrotizing myopathy (IMNM, 7)) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA2000-M), physical activity (Human Activity Profile, HAP questionnaire), serum levels of 27 cytokines/chemokines (commercial multiplex ELISA kit, Bio-Rad Laboratories) and serum levels of selected parameters of nutrition and lipidogram. Disease activity (MITAX and MYOACT activity score) and muscle involvement (manual muscle testing, MMT-8, and functional index 2, FI2) were evaluated. Data are presented as mean±SD.

Results:

Compared to HC, patients with IIM had a trend towards significantly increased body fat % (BF%; iDXA: 39.9±7.1 vs. 42.4±7.1 %, p=0.077), but significantly decreased lean body mass (LBM; iDXA: 45.6±8.1 vs. 40.6±7.2 kg, p=0.001; BIA: 52.6±8.8 vs. 48.7±9.0 kg, p=0.023), increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p<0.001), reflecting deteriorated nutritional status and predisposition for physical activity, and significantly lower bone mineral density (BMD: 1.2±0.1 vs. 1.1±0.1 g/cm2, p<0.001). Disease duration negatively correlated with BMD and LBM-BIA. Disease activity (MITAX, MYOACT) positively correlated with LBM (by BIA and DXA), similarly as with basal metabolic rate (BMR), and fat free mass (FFM). CRP was positively associated with BF% (BIA and DXA). Higher BF%-DEXA was associated with worse physical endurance (FI2) and worse ability to perform physical activity (HAP). MMT-8 score negatively correlated with ECM/BCM ratio. Serum levels of several inflammatory cytokines/chemokines (specifically IL-1ra, MCP, IL-10) and markers of nutrition (specifically albumin, C3-, C4-complement, cholinesterase, amylase, insulin and C-peptide, vitamin-D, orosomucoid), and lipid metabolism (specifically triglycerides, high-density lipoprotein, apolipoprotein A and B, atherogenic index of plasma) were significantly associated with alterations of body composition in IIM patients. (p<0.05 for all correlations)

Conclusion:

Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. These data could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance.

Serum levels of certain inflammatory cytokines/chemokines and markers of nutrition and lipid metabolism were associated with alterations of body composition in IIM patients. This might further support the role of systemic inflammation and nutritional status on the negative changes in body composition of IIM patients.

Acknowledgments:

Supported by AZV NV18-01-00161A, MHCR 023728, SVV 260373 and GAUK 312218

Disclosure of Interests:

Sabina Oreska: None declared, Maja Špiritović: None declared, Petr Česák: None declared, Ondrej Marecek: None declared, Hana Štorkánová: None declared, Barbora Heřmánková: None declared, Kateřina Kubinova: None declared, Martin Klein: None declared, Lucia Vernerová: None declared, Olga Růžičková: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Heřman Mann: None declared, Jiří Vencovský: None declared, Michal Tomčík: None declared

FRI0424 PROGRESSION OF PAIN, STIFFNESS, FUNCTION CHANGES AND ULTRASOUND DETECTED CHANGES IN THE GROUP OF 151 PATIENTS WITH HAND OSTEOARTHRITIS OVER THREE YEARS

Background:

Hand osteoarthritis (HOA) is a common and frequent cause of pain. HOA is a heterogeneous group of disorders with two main subsets including non-erosive and erosive disease. Few studies demonstrated inflammatory ultrasound changes and more severe clinical symptoms in patients with erosive compared with non-erosive disease, however the results are inconsistent.

Objectives:

The aim of this study was to evaluate progression of pain, stiffness, physical impairment and ultrasound features in patients with erosive and non-erosive HOA in a three years longitudinal study.

Methods:

Consecutive patients with symptomatic HOA fulfilling the American College of Rheumatology (ACR) criteria were included in this study. Joint pain and swelling were assessed. Patients reported joint pain on 100 mm visual analogue scale (VAS). Pain, joint stiffness and disability were assessed by the Australian/Canadian OA hand index (AUSCAN). Erosive disease was defined by at least one erosive interphalangeal joint. Synovial hypertrophy and power Doppler signal (PDS) were scored with ultrasound. Synovitis was graded on a scale of 0–3 and osteophytes were defined as cortical protrusions seen in two planes. Patients were examined at baseline and at the first, second and third year of follow-up.

Results:

Altogether, 151 patients (16 male) with symptomatic nodal HOA were included in this study and followed between April 2012 and January 2020. Out of these patients, 84 (4 male) had erosive disease. The disease duration (p<0.05) was higher in patients with erosive compared with non-erosive disease.

Pain reported on VAS was significantly higher (p<0.01) in patients with erosive compared with non-erosive disease at baseline. Progression of pain after the third year of follow up was significantly higher in patients with erosive disease (p<0.01). The number of painful and clinically swollen joints (p<0.05) was significantly higher in patients with erosive compared with non-erosive disease at baseline. It fluctuated over the second and third year of follow up, but it still remained statistically higher (p<0.01) at the third year of follow up in patients with erosive disease.

According to the AUSCAN, patients with erosive compared with non-erosive disease had more pain (p<0.01) and stiffness (p<0.01) at baseline. Pain (p<0.05), stiffness and also function (p<0.05) worsened in patients with erosive compared with non-erosive disease at the third year of follow up.

US-detected pathologies such as gray-scale synovitis (p<0.001), intensity of PDS (p<0.01) and number of osteophytes (p<0.01) were significantly higher in patients with erosive compared with non-erosive disease at baseline. There were improvements in gray-scale synovitis total score and intensity of PDS in patients with non-erosive disease while patients with erosive disease worsened after the second and third year of follow up. US-detected gray-scale synovitis (p<0.001), intensity of PDS (p<0.01) remained significantly higher in patients with erosive compared with non-erosive disease after the third year of follow up. On the other hand, the progression of US-determined osteophyte formation was observed in both groups but was significantly higher (p<0.05) in patients with erosive compared with non-erosive disease after the third year of follow up. .

Conclusion:

The findings of this study show that pain and number of painful and clinically swollen joints associated with US-detected synovial changes and osteophyte formation is more severe in patients with erosive HOA than in patients with non-erosive disease. In addition, osteophyte formation is more likely to progress independent of synovial inflammation.

References:

[1]Meersseman P, Van de Vyver C, Verbruggen G, et al. Clinical and radiological factors associated with erosive radiographic progression in hand osteoarthritis. Osteoarthritis and Cartilage 2015;23:2129-2133.

Acknowledgments:

This work was supported by the project MHCR 023728 and AZV No. 18-00542.

Disclosure of Interests:

Olga Sleglova: None declared, Olga Růžičková: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared

Bronchial inflammation in seasonal allergic rhinitis with or without asthma in relation to natural exposure to pollen allergens

BACKGROUND

Nasal inflammation in allergic rhinitis enhances bronchial Th2 driven inflammation and development of asthma. We assessed bronchial inflammation induced by natural allergen exposure during pollen season in patients with pollinosis with or without asthma to show the intensity of inflammation in asthma and rhinitis and possible persistence of inflammation in periods without allergen exposure.

METHODS

Sputum was induced in 52 patients with seasonal allergic rhinitis without asthma, 38 patients with seasonal allergic rhinitis and seasonal asthma and 23 healthy volunteers. Sampling was performed 6-8 weeks before the expected beginning of symptoms, during symptomatic period and 6-8 weeks after the end of symptoms. Sputum ECP was measured by means of chemi-luminiscent immunometric assay and sputum cell counts were assessed by classical staining and immunocytochemistry.

RESULTS

Sputum eosinophils were on the whole higher in both asthma and rhinitis compared to controls (p<0.001, p=0.003). The rise of eosinophils during pollen season compared with values out of pollen season was significant in asthma (classical staining) (p=0.014) and slightly apparent in rhinitis (immunocytochemistry) (p=0.073). The seasonal rise of sputum ECP was observed only in rhinitis (p=0.006).

CONCLUSIONS

Inflammation of the lower airway in patients with allergic rhinitis with and without asthma has been confirmed by means of both sputum eosinophil count and sputum ECP level. Persistent inflammation of lower airway in periods without allergen exposure was proven in seasonal asthma. This may have implications for the therapy of seasonal allergic rhinitis with and without asthma in terms of promoting long-term anti-inflammatory treatment.