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Elevated autoantibody content in rheumatoid arthritis synovia with lymphoid aggregates and the effect of rituximab
Arthritis Research & Therapy, 09/05/08

Rosengren S et al. – Combined with earlier observations that synovial lymphoid aggregates survived rituximab treatment, these data suggest that lymphoid aggregates may provide a protective niche for autoantibody producing cells.

Methods

Study to evaluate the contribution of synovial lymphoid aggregates to autoantibody, total immunoglobulin production in RA pts, and the effect of the B-cell depleting ab, rituximab
Autoantibodies, total IgM and IgG were quantified by ELISA in extracts of synovial tissues and matched serum
Synovial biopsies and serum were obtained at baseline and 8 wks following rituximab therapy in 14 RA pts

Results

Anti-CCP IgG, but not RF-IgM, was enriched in RA synovia vs serum
Total IgM and IgG was also enriched in RA, but not in OA
SSI correlated with mRNA content for both IgM and IgG
RA synovia with lymphocyte aggregates contained elevated RF-IgM and anti-CCP IgG vs tissues with diffuse lymphoid infiltration
Rituximab treatment did not affect synovial autoantibody or total Ig SSI overall
In aggregate-containing tissues, rituximab reduced total IgM and IgG SSI as well as IgM and IgG1 mRNA
RF-IgM and anti-CCP IgG synovial/serum indices were unchanged by rituximab in aggregate-containing synovial