OP0165 JAK3-STAT5 SIGNALING PATHWAY IS INVOLVED IN THE PATHOGENESIS OF GOUTY INFLAMMATION

Background

Studies have confirmed that JAKs-STATs signaling pathway is involved in the pathogenesis of a variety of autoinflammatory diseases, and has been transformed into the treatment of rheumatic diseases. So far, the research of JAKs-STATs in the mechanism of gout is very limited.

Objectives

To determine whether JAKs-STATs pathway is involved in the pathogenesis of gouty inflammation.

Methods

1.The transcription and protein phosphorylation levels of 4 JAKs (JAK1, JAK2, JAK3 and Tyk2) and 7 STATs (STAT1, stat2, STAT3, STAT4, STAT5a/5b and STAT6) in PBMCs of 100 gout patients (concluding acute gout (AG) and intermittent gout (IG) patients 50 cases, respectively) and 50 healthy subjects (HC) were measured; 2.To detect the changes of JAK3-STAT5 signal pathway in synovium of rat ankle model of gouty inflammation;3.To explore the changes of JAK3-STAT5 signal pathway in synovium of gouty inflammation model after colchicine treatment.

Results

1.The phosphorylation levels of JAK3 and STAT5 in PBMCs,the plasma IL-2 level in the AG group were all significantly higher than those in the HC group (P<0.05, respectively; Figure 1G,H), while there were no differences with respect to the other JAKs and STATs molecules between the two groups (P>0.05, respectively); 2.JAK3 and STAT5 phosphorylation levels in synovial tissue of rat ankle, cytokine IL-1β and IL-2 productions in synovial fluid of rat ankle from gout model were all significantly increased (P<0.05, respectively;Figure 1A-F);3.Phosphorylation levels of JAK3 and STAT5,IL-1β and IL-2 levels were significantly reduced after colchicine treatment (P<0.05, respectively;Figure 1A-F)

Figure 1.

JAK3-STAT5 participates in the pathogenesis of gouty inflammation. In vivo experimental protocol (A-F): A. Male Wistar rats were used. The model Colchicine group was intragastrically administered with 0.104 mg/kg/d colchicine solution, and the Control group was intragastrically administered with the same amount of saline. After 3 days of continuous intragastric administration, the right ankle joint was injected with MSU (8 mg/100μl) or PBS (100 μl) to establish a gout arthritis model(MSU group) or Control group. B. Representative photographs of ankles 12 hr after MSU or PBS injection. C. Representative microscopic photos of ankle tissue sections from Control, MSU and Colchicine groups. D. Representative confocal laser scanning images showed JAK3 protein and its phosphorylated protein staining in ankle tissues in the three groups. Areas staining positive for JAK3 protein are shown in green. Regions staining positive for p-JAK3 protein are shown in red. E. IL-1β and IL-2 production in ankle flushing was detected by ELISA.*P <.05,**P<.01,***P<.001, significantly different from Control group; #P<.05,##P<.01, ###P< .001,significantly different from MSU group. F. At 12 h after MSU injection, JAK3 and STAT5 mRNA, protein in ankle tissues were determined by qRT-PCR and Western blotting, respectively. The panel displays the representative images of JAK3, STAT5, p-JAK3, p-STAT5a and GAPDH protein expression from the three groups.*P <.05,**P<.01,***P<.001, significantly different from Control group; #P<.05,##P<.01, ###P< .001, significantly different from MSU group. G.IL-2 and IL-7 levels in plasma of acute gout(AG), intermittent gout(IG) patients and healthy individuals (HC) were detected using ELISA. *P<.05, **P<.01, ***P < .001. H. JAK3 and STAT5 mRNA, protein levels in PBMCs of AG, IG, and HC groups were measured by qRT-PCR and Western blotting, respectively. *P<.05, **P<.01, ***P < .001.

Conclusion

IL-2-JAK3-STAT5 signaling pathway is involved in the regulation of gouty inflammation. Colchicine could treat gouty inflammation through inhibiting IL-2-JAK3-STAT5 pathway; JAK3 is expected to be a therapeutic target for acute gouty inflammation.

Disclosure of Interests

None declared

POS0349 DECOY RECEPTOR 3 AND ITS SIGNAL PATHWAY CONTRIBUTE TO PATHOGENESIS IN PRIMARY GOUTY ARTHRITIS

Background

Gouty arthritis (GA) is an autoinflammatory disease caused by the deposition of monosodium urate crystal (MSU) in the joints and surrounding tissues, which lead to a series of complex inflammatory cascade amplification reactions.The clinical symptoms of acute GA attack rapidly, but often alleviate spontaneously within 7 ~ 10 days, which is one of the significant characteristics different from other joint diseases or autoimmune diseases. However, the exact molecular mechanism of its inflammatory self limitation is still unclear. The phenotypic imbalance of Th1 / Th2 cells and the M1/ M2 polarization of macrophages may be involved in the inflammatory self limitation of gout[1].Decoy receptor 3 (DCR3) can differentiate T cells into Th2 phenotype, promote M2 polarization of macrophages, and play the functions of immune regulation and repair[2].DCR3 and its Signal Pathway are involved in the pathogenesis of tumors and a variety of autoimmune diseases, and have become an important research target of tumors and immune related diseases.However, studies on DcR3 related molecular pathway and GA are scarce, and the specific regulatory mechanism is unknown.

Objectives

To assess the contribution of DcR3 and its signal pathway to gout and the clinical importance of these genes in primary gouty arthritis.

Methods

The mRNA expression levels of DCR3 and its signal pathway(DR3, TL1A, Fas, FasL, Ligth, LigthR, LTgthRNA expression levels of DCR3 and its signal pathway(DR3gout and the clinical importance of these genes in primary gouty arthritis.nt research target of tumors and immune related diseases.However, studies on DcR3 related moathway expression levels and laboratory features was analyzed in GA patients.

Results

The expression levels of DCR3, FasL were much lower in the AG and IG group than in the HC groups (p<0.05), and no significant difference was detected between AG and IG groups(P>0.05)(a,e). The expression levels of DR3 were much lower in the AG and IG group than in the HC groups (p<0.05), and much lower in the AG group than in the IG groups (p<0.05)(b). The expression levels of TL1A were much higher in the AG group than in the IG and HC groups (p<0.05), and no significant difference was detected between IG and HC groups(P>0.05)(c).The expression levels of Light, LightR were much lower in the AG group than in the HC groups (p<0.05), and no significant difference was detected between AG and IG groups, IG and HC groups(P>0.05)(f,g).The expression levels of LTlower in the AG and IG group than in the HC groups (p<0.05(p<0.05), and no significant difference was detected between AG and IG groups, IG and HC groups(P>0.05)(h).In GA patients, the levels of DcR3 related molecular pathway gene correlated with laboratory inflammatory and metabolic indexes.

Conclusion

Altered DCR3 and its signal pathway expression suggests that DCR3 related molecular pathway is involved in the pathogenesis of GA and participates in regulating inflammation and metabolism.

References

[1]Desai J, Steiger S, Anders HJ. Molecular Pathophysiology of Gout[J]. Trends Mol Med. 2017 Aug;23(8):756-768. DOI:10.1016/j.molmed.2017.06.005.

[2]Pan YG, Huang MT, Sekar P, et al. Decoy Receptor 3 Inhibits Monosodium Urate-Induced NLRP3 Inflammasome Activation via Reduction of Reactive Oxygen Species Production and Lysosomal Rupture[J]. Front Immunol. 2021 Mar 3;12:638676.DOI:10.3389/fimmu.2021.638676.

Figure 1.

Relative Expression of DcR3 related molecular pathway gene in the PBMCs of Patients.The expression levels of DCR3, FasL were much lower in the AG and IG group than in the HC groups (p<0.05)(a,e). The expression levels of DR3 were much lower in the AG and IG group than in the HC groups (p<0.05), and much lower in the AG group than in the IG groups (p<0.05)(b). The expression levels of TL1A were much higher in the AG group than in the IG and HC groups (p<0.05)(c).The expression levels of Light, LightR were much lower in the AG group than in the HC groups (p<0.05)(f,g).The expression levels of LTβR were much higher in the AG group than in the HC groups (p<0.05)(h).

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

AB0702 Coexistence of systemic sclerosis and microscopic polyangitis associated with pulmonary renal syndrome: a case report and literature review

Background

Systemic sclerosis is a chronic immune disease characterized by varying degrees of fibrosis of skin and internal organs. Microscopic polyangitis, as a subtype of ANCA associated vasculitis, mainly involves small blood vessels, often manifested as necrotizing glomerulonephritis and pulmonary capillary vasculitis. Pulmonary renal syndrome is characterized by diffuse alveolar hemorrhage based on pulmonary capillary vasculitis and rapidly progressive glomerulonephritis, which can be derived from a variety of autoimmune diseases, of which ANCA associated vasculitis accounts for about 60%[1]. The cases of coexistence of systemic sclerosis and microscopic polyangitis associated with pulmonary renal syndrome in clinic are rare, which is often dangerous and is easy to miss diagnosis or misdiagnosis.

Objectives

To investigate the clinical characteristics, diagnosis and treatment of coexistence of systemic sclerosis (SSC) and microscopic polyangitis（MPA）associated with pulmonary renal syndrome (PRS).

Methods

The clinical data, diagnosis and treatment process of a patient who has SSC combined with MPA and PRS were summarized and analyzed. And the literature was reviewed to explore the correlation of the pathogenesis and clinical experience of SSC complicated with MPA and PRS.

Results

The case is a middle-aged male who was diagnosed as SSc due to the hardening of the skin of both hands，Reynolds phenomenon, the anti-scl-70 antibody are positive. The patient suffered from repeated hemoptysis, progressive dyspnea, severe anemia and renal insufficiency, so he was diagnosed as MPA with PRS. After giving glucocorticoid, immunosuppressant and anti-infection treatment, his condition has improved. A total of 7 case reports were retrieved by reviewing the relevant literature.A total of 7 patients were reported.They were first diagnosed as SSc and then MPA with PRS, of which 4 cases improved after treatment and 3 cases died. Among the dead patients, 1 case was treated with penicillamine for 3 years, and the remaining 2 cases were only treated with steroids without immunosuppressants.In SSc, P-ANCA is closely related to vasculitis, and the prognosis of PRS secondary to P-ANCA may be very poor. Most of the diagnosis of MPA is only after patients have kidney or lung diseases.There is a certain correlation between them in pathogenesis. Glucocorticoids, immunosuppressants, biological agents, hemodialysis and plasma exchange are the main treatments.

Conclusion

Although the cases of SSc combined with MPA and PRS are rare, there are still many cases reported,which reminds us: ①When SSc patients have new symptoms such as renal insufficiency or lungs, they should be alert to new entities that may be combined with other autoimmune diseases to avoid missed diagnosis or misdiagnosis.②ANCA should be detected in SSc patients at baseline, which may be related to disease activity.③PRS has rapid progress and high mortality, whcih is an emergency that needs urgent treatment. Such patients should be treated with glucocorticoid, immunosuppression and plasma exchange immediately. However, if patients are complicated with SSc, they need to be extra careful when using high-dose steroids, which increases the risk of renal crisis.

References

[1]de Groot K, Schnabel A. Das pulmorenale Syndrom [Pulmonary-renal syndrome]. Internist (Berl). 2005;46(7):769-782. doi:10.1007/s00108-005-1423-8.

Figure 1.

The contrast of chest CT before and after treatment showed that the exudative lesions of both lungs were significantly absorbed

Figure 2.

Clinical data of systemic sclerosis combined with microscopic polyangitis and pulmonary renal syndrome

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

AB0334 EFFICACY AND SAFETY OF ABATACEPT IN CHINESE PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: REAL-WORLD DATA

Background

Abatacept (ABA) has demonstrated efficacy and safety in active rheumatoid arthritis (RA) patients in Europe and the United States as one of bDMARDs [1]. However, the clinical activity of Abatacept (ABA) has not been sufficiently investigated in patients with RA from a real-world clinical setting in China.

Objectives

This study was designed to investigate the efficacy and safety of Abatacept in the RA patients in Chinese population who were refractory to csDMARDs, aiming to provide further reference for clinical rational drug use.

Methods

Clinical data of 55 patients with active RA who were admitted in the Affiliated Hospital of North Sichuan Medical College from June 2020 to June 2021 and did not respond to csDMARDs was retrospectively analyzed. Patients in this study were treated with Abatacept (125 mg by subcutaneous injection once weekly combined with csDMARDs. Changes in clinical manifestations, including DAS28-ESR, CDAI, ACR 20/50/70 at week 12 and 24 from baseline and AEs during 24 weeks were observed and recorded.

Results

55 patients (46 women and 9 men) were included in this study with a mean age 50.80 ± 12.46 and a mean disease duration of 6.29 ± 6.22 years. The ACR 20 response at week 12 and 24 was 50.91% (28/55) and 87.27% (48/55), respectively. Besides, DAS 28-ESR score were significantly lower at week 12 and 24 compared to baseline (P <0.05) with 19 patients (34.55%) achieving clinical remission or low disease activity. Changes in CDAI scores revealed that 80% patients achieved clinical remission or low disease activity at week 24. DAS28-ESR score was significantly lower in previously untreated patients (Biologic-naive) (n=36) (3.40 ± 0.81) than in the previously treated patients (Biologic non-naive) (n=19) (3.83 ± 0.68) (P = 0.02) (Figure 1). RF, CCP antibody and GLOB levels were significantlyreduced in RA patients after 24-week ABA treatment compared to baseline (P﹤0.05) (Table 1). Two hepatitis B virus (HBV) carriers, two patients with active tuberculosis and one patient with latent tuberculosis status showed no reactivation of HBV and no new active tuberculosis lesions 24 weeks after treatment with ABA. AEs were reported in 9.1% (5/55), but no serious infections occurred.

Table 1.

Analysis of clinical and serological parameters at baseline and after treatment with Abatacept.

IndexesBaseline12 weeks24 weeksTJC6 (4，10)3 (2，4)*2 (1，3) **SJC2 (1，4)1 (0，2)*0 (0，1)**PtGA-VAS（0-10cm）8 (7，10)5 (3，6)*2（2，3）**HAQ2 (0，4)1 (0，2)*0 (0，1)**ESR （mm/h）51 (41，89)37 (28，51)*23 (17，37)**HsCRP（mg/L）14.08 (3.7，35.0)5，77 (2.27，20.78) *4.12 (1.34，9.37) **GLOB34.47±5.69-30.33±3.81*RF-IgM (IU/mL)408.55 (68.8,566.5)-167.41 (34.9, 171.25) *RF-IgG (U/mL)8.63 (4.55, 11.1)-7.94 (3.13, 6.23) *RF-IgA (U/mL)90.18 (25.63, 99.12)-58.20 (16.81, 59.09) *CCP (RU/mL)1095.45 (66.79, 1033.28)-782.0 (58.49, 857.5) *

*p﹤0.05,TJC=Tender joint count, SJC=Swollen joint count, GLOB= immunoglobulin.

Conclusion

In the Chinese patients with active RA refractory to csDMARDs, the combination of ABA and csDMARDs showed great clinical efficacy and a favorable safety profile. Moreover, ABA resulted in better efficacy in patients previously untreated with biologics than previously treated with biologics.

References

[1]Weinblatt ME, Schiff M, Valente R,et al. Head-to-head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: findings of a phase IIIb, multinational, prospective, randomized study. Arthritis Rheum 2013; 65:28-38.

Disclosure of Interests

None declared

OP0114 IDENTIFICATION AND FUNCTIONAL PREDICTION OF LONG NONCODING RNA RELATED TO CONNECTIVE TISSUE DISEASE-ASSOCIATED INTERSTITIAL LUNG DISEASES

Background

Recently, the role of long noncoding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention1. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited.

Objectives

To explore the expression profile of lncRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients and the possible mechanisms of significantly differentially expressed lncRNA involved in CTD-ILD, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.

Methods

LncRNA microarray analysis was used to identify the pattern of lncRNA dysregulation between CTD-ILD and connective tissue disease without associated interstitial lung disease (CTD-NILD). Differential genes were identified by bioinformatic analysis. Relative expression levels of five differentially expressed lncRNAs in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription PCR (qRT-PCR).

Results

The differential gene expression analysis revealed 46 lncRNAs were upregulated while 194 lncRNAs were downregulated in the CTD-ILD group compared to the CTD-NILD group (Figure 1). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses identified several significant biological processes and signaling pathways, including NF-kappa B signaling pathway, IL-17 signaling pathway, Toll-like receptor signaling pathway, B cell receptor signaling pathway. QRT-PCR confirmed that the selected target genes were differentially expressed in different groups. In particular, the ENST00000604692 expression level was significantly higher in the ILD than the NILD group (p<0.05, Figure 1); T311354 and arginase-1were significantly higher in SSc than RA group; Furthermore, the area under receiver operating characteristic curve for ENST00000604692 in predicting ILD from NILD was 0.797 (Figure 1).

Conclusion

This research has demonstrated, for the first time, the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD. ENST00000604692 can effectively distinguish ILD group from NILD group,which may be a diagnostic indicator of CTD-ILD, especially SSc-ILD and RA-ILD.

References

[1]Guo CJ, Xu G, Chen LL. Mechanisms of Long Noncoding RNA Nuclear Retention. Trends Biochem Sci (2020) 45(11):947-60. doi: 10.1016/j.tibs.2020.07.001.

Disclosure of Interests

None declared

AB0112 DECOY RECEPTOR 3 AND ITS SIGNAL PATHWAY CONTRIBUTE TO PATHOGENESIS IN ANKYLOSING SPONDYLITIS

Background

Ankylosing spondylitis (AS) is a chronic progressive disease with invasion of spine and sacroiliac joint as the main clinical manifestation, which can be combined with systemic inflammation or abnormalities in multiple parts at the same time. There are complex changes of immune function in patients with AS, and its immune and genetic pathogenesis is still unclear. Decoy receptor 3 (DcR3), as a new immune molecule discovered in recent years, plays an important role in regulating T cell activation, proliferation, differentiation and apoptosis.Studies have confirmed that DcR3 is involved in the immune disorder process of rheumatoid arthritis, SLE, AS and other autoimmune diseases, so that the role of DcR3 in AS has attracted attention. However, the expression of DcR3 related pathway genes[1-3].However, studies evaluating the DcR3 related pathway genes in AS are scarce.

Objectives

To assess the contribution of DcR3 and its signal pathway to AS and the clinical importance of these genes in AS.

Methods

The mRNA expression levels of DCR3 and its signal pathway(DR3、TL1A、Fas、FasL、Ligth、LigthR、LTgthRNA expresured in peripheral blood mononuclear cells (PBMCs) from 50 AS patients and 50 healthy subjects. The relationship between DCR3 related molecular pathway expression levels and laboratory features was analyzed in AS patients.

Results

The expression levels of DCR3、DR3、Fas、Light were much lower in the AS group than in the HC groups (p<0.05)(a,b,c,d), and the expression levels of LT The relationship between DCR3 related molecular pathway expression l

Conclusion

Compared with HC group, DCR3 and its signal pathway in PBMCs of AS patients are differentially expressed. It is speculated that DcR3 related molecular pathway gene may be involved in the pathogenesis of AS.

Figure 1.

Relative Expression of DcR3 related molecular pathway gene in the PBMCs of Patients. The mRNA levels in PBMCs from AS patients(n=50) and HCs(n=50) were measured by RT-qPCR. The expression levels of DCR3ˎDR3ˎFasˎLight were much lower in the AS group than in the HC groups (p<0.05)(a,b,c,d), and the expression levels of LTβR was much higher in the AS group than in the HC groups (p<0.05)(e).

References

[1]Lee CS, Hu CY, Tsai HF, et al. Elevated serum decoy receptor 3 with enhanced T cell activation in systemic lupus erythematosus. Clin Exp Immunol. 2008;151(3):383-390. doi:10.1111/j.1365-2249.2007.03579.x

[2]Hayashi S, Miura Y, Tateishi K, Takahashi M, Kurosaka M. Decoy receptor 3 is highly expressed in patients with rheumatoid arthritis. Mod Rheumatol. 2010;20(1):63-68. doi:10.1007/s10165-009-0240-7.

[3]Chen MH, Chen WS, Tsai CY, Liao HT, Chen CH, Chou CT. Overexpression of decoy receptor 3 in synovial tissues of inflammatory arthritis. Clin Exp Rheumatol. 2012;30(2):171-177.

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

[Recommendations of diagnosis of autoinflammatory diseases in China]

Autoinflammatory diseases (AIDs) are a group of disorders characterized by dysfunction of innate immunity which caused by gene mutations leading to coded proteins changes, finally causing uncontrolled systemic inflammation. AIDs are a group of rare rheumatic and inflammatory diseases. Here, Chinese Rheumatology Association summarized manifestations of the main AIDs, and to standardize the methods for diagnosis of AIDs.

AB0011 EXPRESSION PROFILE AND POTENTIAL FUNCTION OF CIRCRNAS IN PERIPHERAL BLOOD MONONUCLEAR CELLS FROM PATIENTS WITH PRIMARY GOUT

Background:

Autophagy is a phenomenon of “self-phagocytosis” in eukaryotic cells, which maintains cell homeostasis by transporting intracellular materials to lysosomes for degradation and recycling. In recent years, studies have shown that autophagy may be involved in the pathogenesis of rheumatoid arthritis(RA)[1], but its specific mechanism is still unclear.

Objectives:

The expression levels of autophagy-related genes(ATG) unc-51-like kinase 1(ULK1), ATG13, ATG17, microtubule associated protein 1 light chain 3 (LC3), and P62 in peripheral blood mononuclear cells (PBMC) of patients with RA were detected, and their role and clinical significance in the pathogenesis of RA were explored.

Methods:

Real-time fluorescent quantitative PCR was performed to detect the expression levels of ULK1, ATG13, ATG17, LC3, and P62 in PBMCs of 50 RA patients, 50 healthy controls (HC), and 25 moderate to severe RA patients before and after treatment. Then, t test, χ2 test, Mann-Whitney U test, Pearson test were used for statistical analysis.

Results:

1.The levels of hsCRP, white blood cell(WBC), neutrophils(GR), platelet(PLT) and plateletcrit(PCT) in RA group were higher than those in HC group (P <0.05). Lymphocytes (LY), red blood cell(RBC), hemoglobin(HGB), hematocrit(HCT), mean corpuscular hemoglobin(MCH), mean red blood cell volume(MCV) and mean red blood cell hemoglobin concentration(MCHC) in RA group were lower than those in HC group (P <0.05). 2.The expressions of ULK1, ATG17, and LC3 in RA group were higher than those in HC group, while the expressions of P62 was lower than those in HC group(P<0.05) (Figure 1). The correlation analysis suggested that ATG17 was positively correlated with tender joint count (TJC), swollen joint count (SJC), and health assessment questionnaire (HAQ) (P<0.05); ULK1 and HAQ were negatively correlated (P<0.05).3. Compared with before treatment with TNFi, ATG17, HAQ, DAS-28, ESR, hsCRP, WBC, GR, PLT and PCT were significantly reduced after treatment (P<0.05); the expressions of RBC, HCT, MCV and MCH were significantly increased after treatment,(P<0.05); ULK1, ATG13, LC3, P62 and other related clinical and laboratory indicators were not significantly different before and after treatment with TNFi (P>0.05).

Figure 1.

The expression levels of ATGs in HC and RA groups.

Conclusion:

There is abnormal expression of autophagy genes in the peripheral blood of RA patients. ULK1, ATG17, LC3 and P62 may be related to the pathogenesis of RA, among them, ATG17 may regulate the pathogenesis of RA by participating in the TNF-α pathway.

References:

[1]Rockel Jason S,Kapoor Mohit,Autophagy: controlling cell fate in rheumatic diseases.[J].Nat Rev Rheumatol, 2016, 12: 517-31.

Disclosure of Interests:

Yu-Feng Qing Grant/research support from: Science and Technology Project of Nanchong City (no.18SXHZ0522), Fei Dai: None declared, Quan-Bo Zhang Grant/research support from: the National Natural Science Foundation of China(General Program) (no.81974250), and Science and Technology Plan Project of Sichuan Province (no.2018JY0257), Yi-Ping Tang: None declared, Zeng-Rong Dong: None declared, Yi-Xi He: None declared, Yi Jiang: None declared, Yu-Qin Huang: None declared, Jianxiong Zheng: None declared

AB0075 HSA_CIRC_0012732, HSA_CIRC_0008961, HSA_CIRC_0405239 AND HSA_CIRC_0068784 MIGHT BE INVOLVED IN THE PATHOGENESIS AND DEVELOPMENT OF ANKYLOSING SPONDYLITIS

Background:

CircRNAs have been found to be involved in the occurrence and development of many rheumatic diseases[1-2]. Are circRNAs involved in the pathogenesis of ankylosing spondylitis (AS)? How do these circRNAs participate in the pathogenesis of AS? This all needs further study.

Objectives:

This study is to clarify the expression levels of hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 in the peripheral blood of AS patients, and to explore whether these circRNAs are involved in the pathogenesis of AS.

Methods:

To collected 60 cases of AS (30 cases of active AS (ASA): BASDA> 6 or 6> BASDAI> 4, ESR> 22mm / h or 6> BASDAI> 4, hsCRP> 9mg / L; 30 cases of stable AS (ASS): BASDAI <4) and 30 health control (HC) peripheral blood samples, related clinical and laboratory indicators. The relative expression levels of hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 in each group were detected by real-time quantitative polymerase chain reaction (qPCR). The relationships between the 4 circRNAs and clinical and laboratory indicators were explored by correlation analysis.

Results:

1. The qPCR results suggested that the expression of hsa_circ_0012732 between the ASA and ASS groups was statistically significant (p<0.05), and the expression of hsa_circ_0008961 was statistically significant between the ASA and HC groups (p<0.05). Howeverthere was no statistical significance among other groups (p>0.05)Figure 1. Similarly, the expression level of hsa_circ_0405239 was not statistically significant among the groups (p>0.05), and the same was true for hsa_circ_0068784 (p>0.05).

2. Correlation analysis results (Figure 2) showed that hsa_circ_0012732 is positively correlated with lymphocyte count (LY), mean corpusular volume (MCV), albumin (ALB), and negatively correlated with Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), high sensitivity C-reactive protein (hsCRP), Globulin (GLOB) (p<0.05); hsa_circ_0008961 is negatively correlated with platelet (PLT) (p<0.05); hsa_circ_0405239 is negatively correlated with BASDAI and BASFI; hsa_circ_0068784 was negatively correlated with BASDAI (p<0.05); and there was no statistically significant (p>0.05) between these 4 circRNAs and other indicators.

Conclusion:

Hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 may be related to the pathogenesis of AS. Among them, hsa_circ_0012732 may be involved in AS inflammation and has the potential to participate in the judgment of disease activity.

References:

[1]LS, K., et al., The biogenesis, biology and characterization of circular RNAs. 2019. 20(11): p. 675-691.

[2]J, W., et al., Non-coding RNAs in Rheumatoid Arthritis: From Bench to Bedside. 2019. 10: p. 3129.

Disclosure of Interests:

Yi-Ping Tang Grant/research support from: Science and Technology Project of Nanchong City (18SXHZ0522)., Yu-Feng Qing: None declared, Zeng-Rong Dong: None declared, Fei Dai: None declared, Jianxiong Zheng: None declared, Yi Jiang: None declared, Yi-Xi He: None declared, Quan-Bo Zhang Grant/research support from: National Natural Science Foundation of China(General Program) (81974250); Science and Technology Plan Project of Sichuan Province (2018JY0257)

AB0449 CLINICAL CHARACTERISTICS AND RISK FACTORS OF SYSTEMIC SCLEROSIS WITH HEMATOLOGIC SYSTEM DAMAGES

Background:

SSc characterized by varying degrees of fibrosis of the skin and internal organs, clinicians pay more attention to skin and viscera conditions, tend to ignore hematologic system damage. Studies have shown that rheumatic disease such as SLE, RA, pSS often accompanied with hematologic system damages, and hematologic system damages is multiple organ involvement and risk factor of poor prognosis[1-2].

Objectives:

To investigate the the clinical features, laboratory characteristics and risk factors of Systemic Sclerosis (SSc) patient with hematologic system damages.

Methods:

The clinical data of 180 patients were collected from January 2010 to April 2020, at the Affiliated Hospital of North Sichuan Medical College. The demographic information, laboratory tests, and clinical symptoms were analyzed retrospectively.

Results:

Among 180 SSc patients, 70(38.9%) cases were complicated with hematologic system damages. 51(72.9%) cases had anemia, 24 cases (34.3%) had leukopenia, 24 cases (34.3%) had thrombocytopenia, and 22 cases had hematologic system damages associated with more than two cell line involvement. Clinical symptoms: arthritis was significantly higher in the hematologic system damages group than patient without (P<0.05), however, there was no significantly difference in gender, age, disease course, respiratory symptoms, gastrointestinal symptoms, Raynaud’s phenomenon, interstitial lung disease and pulmonary hypertension (all P>0.05). Laboratory tests: ESR and hsCRP were increased in the hematologic system damages group, while the albumin decreased (all P<0.05). The positive rates of resistance to anti-dsDNA antibody and anti-ribosomal P protein antibody was higher in the hematologic system damages group (all P<0.05). Prognosis: During follow-up, leukopenia was more likely to recover, while the thrombocytopenia was more difficult to recover. Logistics regression analysis showed that positive of anti-ribosomal P protein antibody maght be a risk factor for SSc complicated with hematologic system damages [OR = 3.930(P<0.05)] (Table 1).

Conclusion:

SSc complicated with hematologic system damages is common, and patients with hematologic system damages have more serious clinical symptoms, some of whom have difficulty in recovey. Anti-ribosomal P protein antibody may be a risk factor of SSc hematologic system damages.

Table 1.

Bivariate logistics regression analysis on risk factors associated with hematologic damages in SSc.

FactorBSEWaldOR(95%CI)P valuearthritis0.6540.3473.5431.922(0.973-3.797)0.060ESR-0.0810.4870.0280.922(0.355-2.393)0.868hsCRP-0.0070.4920.0000.993(0.379-2.607)0.989anti-dsDNA0.8680.6731.6642.393(0.637-8.916)0.197anti-Rib-P1.3690.6364.6333.930(1.130-13.666)0.031

References:

[1]González-Naranjo L A, Betancur O M, Alarcón G S, et al. Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort[J]. Seminars in Arthritis and Rheumatism, 2016,45(6):675-683.DOI:10.1016/j.semarthrit.2015.11.003.

[2]Skare T, Damin R, Hofius R. Prevalence of the American College of Rheumatology hematological classification criteria and associations with serological and clinical variables in 460 systemic lupus erythematosus patients[J]. Revista Brasileira de Hematologia e Hemoterapia, 2015,37(2):115-119.DOI:10.1016/j.bjhh.2015.01.006

Disclosure of Interests:

None declared.

POS1146 NONCODING RNA CONTRIBUTE TO PATHOGENESIS IN PRIMARY GOUTY ARTHRITIS

Background:

Gout is an arthritic disease caused by the deposition of monosodium urate crystal (MSU) in the joints, which can lead to acute inflammation and damage adjacent tissue [1].Over the past decade, noncoding RNAs (ncRNAs) have been shown to have crucial importance in health and disease[2,3]. However, studies evaluating the function of ncRNAs in gout are scarce, and current knowledge of the role of ncRNAs in gout is still limited.

Objectives:

To assess the contribution of noncoding RNAs to gout and the clinical importance of these genes in primary gouty arthritis (GA).

Methods:

The mRNA expression levels of noncoding RNAs (LINC00173, LINC00963, LINC01330 and miRNA-182-5p) were measured in peripheral blood mononuclear cells (PBMCs) from 60 gout patients(including 30 acute gout patients, 30 intercritical gout patients) and 40 healthy subjects. The relationship between noncoding RNA expression levels and laboratory features was analyzed in GA patients.

Results:

The expression levels of LINC00173, LINC00963 and miRNA-182-5p were much lower in the AG and IG group than in the HC groups (p<0.05), and no significant difference was detected between AG and IG groups(P>0.05). The expression levels of LINC01330 were much lower in the AG group than in the IG and HC groups (p<0.05), and no significant difference was detected between AG and IG groups(P>0.05). In GA patients, the levels of noncoding RNAs mRNA correlated with laboratory inflammatory and metabolic indexes.

Conclusion:

Altered noncoding RNAs expression suggests that noncoding RNAs is involved in the pathogenesis of GA and participates in regulating inflammation and metabolism.

References:

[1]Xu Yi-Ting,Leng Ying-Rong,Liu Ming-Ming et al. MicroRNA and long noncoding RNA involvement in gout and prospects for treatment.[J].Int Immunopharmacol, 2020, 87: 106842.doi:10.1016/j.intimp.2020.106842

[2]Yu Yunfang,Zhang Wenda,Li Anlin et al. Association of Long Noncoding RNA Biomarkers With Clinical Immune Subtype and Prediction of Immunotherapy Response in Patients With Cancer.[J].JAMA Netw Open, 2020, 3: e202149.doi:10.1001/jamanetworkopen.2020.2149

[3]Zou Yaoyao,Xu Siqi,Xiao Youjun et al. Long noncoding RNA LERFS negatively regulates rheumatoid synovial aggression and proliferation.[J].J Clin Invest, 2018, 128: 4510-4524.doi:10.1172/JCI97965

Figure 1.

Relative Expression of noncoding RNAs in the PBMCs of Patients.

Disclosure of Interests:

Quan-Bo Zhang Grant/research support from: the National Natural Science Foundation of China(General Program) (no.81974250) and Science and Technology Plan Project of Sichuan Province (no.2018JY0257), Yu-Qin Huang: None declared, Fan-Ni Xiao: None declared, gui-lin jian: None declared, Yi-Ping Tang: None declared, Fei Dai: None declared, Jian-Xiong Zheng: None declared, Yu-Feng Qing Grant/research support from: Science and Technology Project of Nanchong City (no.18SXHZ0522).

POS0430 EXPRESSION AND CLINICAL SIGNIFICANCE OF AUTOPHAGY-RELATED GENES IN PERIPHERAL BLOOD MONONUCLEAR CELLS OF SYSTEMIC SCLEROSIS

Background:

Growing evidences have demonstrated that autophagy is a powerful regulators in the pathogenesis of fibrosis and autoimmune diseases. Autophagy abnormalities in SSc involve abnormal autophagy-related protein and autophagy-related gene polymorphism[1-2], however there is a few reports on the expression and clinical significance of autophagy-related genes.

Objectives:

To investigate the expression and clinical significance of autophagy-related genes LC-3 mRNA, Becline-1 mRNA, Agt-3 mRNA, Agt-5 mRNA, Agt-12 mRNA and Agt-16L1 mRNA in peripheral blood mononuclear cells (PBMC) of systemic sclerosis (SSc).

Methods:

51 cases of SSc and 60 cases of normal control were received from the Affiliated Hospital of North Sichuan Medical College, and autophagy-related genes were detected by RT-PCR. SPSS19.0 statistical software was used to compare the expression of autophagy-related genes between groups and analyze the relationship between autophagy-related genes and clinical data, P<0.05 was considered statistically significant

Results:

LC-3, Becline-1, and Agt-3 were highly expressed in SSc compared with normal control [LC-3: 0.78(0.60) ×10-3 vs. 0.52(0.54) ×10-3; Beclin-1: 6.68(3.56)×10-3 vs. 5.22(3.54)×10-3; Agt-3: 17.58(12.33)×10-3 vs. 11.00(4.56)×10-3, P<0.05], however Agt-5, Agt-12 and Agt-16L1 of autophagy-related genes were not statistically significant [AGT-5: 6.67(3.58) ×10-3 vs. 6.67(2.64) ×10-3; AGT-12: 8.64(5.56)×10-3 vs. 8.57(4.66)×10-3; Agt-16L1: 2.69(2.19)×10-3 vs. 2.52(2.26)×10-3] (Figure 1). Beclin-1 and Agt-5 high expressed in SSc with the positive of anti-SSA/Ro antibody. LC-3 was positively correlated with Age(r=0.662) and ESR(r=0.355) (all P<0.05).

Conclusion:

Autophagy-related genes were increased in PBMC of SSc, and were correlated with Age, ESR and autoantibody, suggested that autophagy is a key feature in the pathogenesis of systemic sclerosis.

Figure 1.

The relative expression of autophagy-related genes

References:

[1]LIU C, ZHOU X, LU J, et al. Autophagy mediates 2-methoxyestradiol-inhibited scleroderma collagen synthesis and endothelial-to-mesenchymal transition induced by hypoxia[J]. Rheumatology, 2019;58(11):1966–1975.

[2]Mayes M D, Bossini-Castillo L, Gorlova O, et al. Immunochip Analysis Identifies Multiple Susceptibility Loci for Systemic Sclerosis[J]. The American Journal of Human Genetics, 2014,94(1):47-61.DOI:10.1016/j.ajhg.2013.12.002.

Disclosure of Interests:

None declared

POS0136 ROLES OF AUTOPHAGY IN THE PATHOGENESIS OF PRIMARY GOUTY ARTHRITIS

Background:

Gout is a chronic autoinflammatory disease caused by monosodium urate (MSU) crystal deposition [1].Acute gout is characterized by an acute inflammatory reaction that resolves spontaneously within a few days[2], which is one of the distinguishing features of gout compared to other arthropathies or self-inflammatory diseases. Autophagy is a lysosomal degradation pathway that is essential for cellular growth, survival, differentiation, development and homeostasis [3]. Studies have demonstrated that autophagy might play a key role in the pathogenesis of primary gouty arthritis (GA) [4-7]. However, the roles of autophagy in the development of gout have not yet been elucidated.

Objectives:

The aim of our study was to investigate the changes in autophagy-related gene (ATG) mRNA and protein in patients and the clinical importance of these genes in primary gouty arthritis (GA) and to explore the roles of autophagy in the pathogenesis of GA.

Methods:

The mRNA and protein expression levels of ATGs (ATG3, ATG7, ATG10, ATG5, ATG12, ATG16L1, ATG4B and LC3-2) were measured in peripheral blood mononuclear cells (PBMCs) from 196 subjects, including 57 acute gout patients (AG group), 57 intercritical gout patients (IG group) and 82 healthy control subjects (HC group). The relationship between ATG expression levels and laboratory features was analyzed in GA patients.

Results:

The expression levels of ATG4B, ATG5, ATG12, ATG16L1, ATG10 and LC3-2 mRNA were much lower in the AG group than in the IG and HC groups (p<0.05), while the ATG7 mRNA level was much higher in the AG group than in the IG and HC groups (p<0.05). The protein expression levels of LC3-2, ATG3, ATG7 and ATG10 were much higher in the AG group than in the other groups, while those of ATG5, ATG12, ATG16L1 and ATG4B were far lower in the AG group than in the other groups (p<0.05). In GA patients, the levels of ATG mRNA and protein correlated with laboratory inflammatory and metabolic indexes.

Conclusion:

Altered ATG expression suggests that autophagy is involved in the pathogenesis of GA and participates in regulating inflammation and metabolism.

References:

[1]Dalbeth N, Choi HK, Joosten LAB, Khanna PP, Matsuo H, Perez-Ruiz F, et al. Gout. Nat Rev Dis Primers. 2019;5: 69.doi:10.1038/s41572-019-0115-y.

[2]Schauer C, Janko C, Munoz LE, Zhao Y, Kienhöfer D, Frey B, et al. Aggregated neutrophil extracellular traps limit inflammation by degrading cytokines and chemokines. Nat Med. 2014;20: 511-517.doi:10.1038/nm.3547.

[3]Han Y, Zhang L, Xing Y, Zhang L, Chen X, Tang P, et al. Autophagy relieves the function inhibition and apoptosis-promoting effects on osteoblast induced by glucocorticoid. Int J Mol Med. 2018;41: 800-808. doi:10.3892/ijmm.2017.3270.

[4]Yang QB, He YL, Zhong XW, Xie WG, Zhou JG. Resveratrol ameliorates gouty inflammation via upregulation of sirtuin 1 to promote autophagy in gout patients. Inflammopharmacology. 2019;27: 47-56.doi:10.1007/s10787-018-00555-4.

[5]Mitroulis I, Kambas K, Chrysanthopoulou A, Skendros P, Apostolidou E, Kourtzelis I, et al. Neutrophil extracellular trap formation is associated with IL-1β and autophagy-related signaling in gout. PLoS One. 2011;6: e29318.doi: 10.1371/journal.pone.0029318.

[6]Crişan TO, Cleophas MCP, Novakovic B, Erler K, van de Veerdonk FL, Stunnenberg HG, et al. Uric acid priming in human monocytes is driven by the AKT-PRAS40 autophagy pathway. Proc Natl Acad Sci U S A. 2017;114: 5485-5490.doi:10.1073/pnas.1620910114.

[7]Lee SS, Lee SW, Oh DH, Kim HS, Chae SC, Kim SK. Genetic analysis for rs2241880(T > C) in ATG16L1 polymorphism for the susceptibility of Gout. J Clin Rheumatol. 2019;25: e113-e115.doi:10.1097/rhu.0000000000000685.

Disclosure of Interests:

Yu-Qin Huang: None declared, Quan-Bo Zhang Grant/research support from: National Natural Science Foundation of China(General Program) (no.81974250) and Science and Technology Plan Project of Sichuan Province (no.2018JY0257), Jian-Xiong Zheng: None declared, gui-lin jian: None declared, tao-hong liu: None declared, Xin He: None declared, fan-ni xiao: None declared, qin xiong: None declared, Yu-Feng Qing Grant/research support from: Science and Technology Project of Nanchong City (no.18SXHZ0522)

Changes in the expression of telomere maintenance genes might play a role in the pathogenesis of systemic lupus erythematosus

Previous studies demonstrated that telomerase activity increased while telomere length shortened in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE). This study aimed to examine the changes of telomere maintenance genes and their clinical significance in SLE. The mRNA level of telomeric proteins in PBMCs, including shelterin complex (TRF1, TRF2, POT1, TPP1, TIN2 and hRAP1), a set of multifunctional proteins involved in telomere maintenance (MRE11, KU80 and RPA1), and Ki67, was measured using real-time quantitative PCR in 56 SLE patients (36 treated and 20 untreated; 32 with renal involvement and 24 without renal involvement) and 46 healthy subjects (controls). The expression of TPP1, TIN2, POT1 and KU80 was significantly reduced while that of TRF2 and MRE11 increased in SLE patients ( p < 0.05, respectively); significant difference was not found in the expression of TRF1, hRAP1, RPA1 and Ki67 ( p > 0.05, respectively). The expression of TRF2, MRE11 and Ki67 was much higher in untreated SLE patients than in controls or treated SLE patients ( p < 0.05, respectively); the expression of hRAP1 was much higher in SLE patients with renal involvement than in controls or SLE patients without renal involvement ( p < 0.05, respectively). Significant positive correlation was found between level of KU80 and C3, TPP1 and TIN2, TPP1 and POT1, while significant negative correlation was found between KU80 and serum total globulins, TIN2 and RF, TPP1 and SLEDAI score ( p < 0.05, respectively). In conclusion, altered expression of telomere maintenance genes might be involved in the pathogenesis of SLE. Further study in expression and functions of telomeric proteins would be needed.