The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Study Elucidates Potential Flare Pathways in Rheumatoid Arthritis

Study Elucidates Potential Flare Pathways in Rheumatoid Arthritis

December 14, 2020 • By Ruth Jessen Hickman, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Alpha Tauri 3D Graphics / shutterstock.comResearch in The New England Journal of Medicine has opened new avenues for exploring the pathophysiology of disease flares in rheumatoid arthritis.1 Through longitudinal genomic analysis, researchers have identified a naive B cell signature prior to rheumatoid arthritis flares, as well as a type of mesenchymal cell, that may play an important role in flare pathways.

You Might Also Like
  • Synovial Analysis Identifies Distinct Rheumatoid Arthritis Subtypes
  • Survivin Essential for the Maturation of Antigen Presenting Cells in Rheumatoid Arthritis Patients
  • The Role of Autoreactive B Cells in Rheumatoid Arthritis
Explore This Issue
December 2020
Also By This Author
  • The Demise of the Inpatient Rheumatology Unit

Background

The first author of the paper, “RNA Identification of PRIME Cells Predicting Rheumatoid Arthritis Flares,” Dana E. Orange, MD, assistant professor of clinical investigation at the Rockefeller University and assistant attending rheumatologist at the Hospital for Special Surgery, New York, explains, “We started this study because we noticed a gap in understanding how rheumatoid arthritis develops—a gap between the known risk factors for developing a diagnosis of rheumatoid arthritis and the actual patient experience of flares.”1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Although researchers have identified certain genes and environmental factors, such as smoking, that increase the risk of rheumatoid arthritis, much about the immediate cause of disease flares remains poorly understood. To help address these questions, Dr. Orange et al. collected longitudinal genomic data from a cohort of patients, allowing the authors to compare differences in gene expression prior to flares, during flares and during quiescence.

As pointed out in an accompanying editorial, previous analyses utilizing micro-
array technology had not yielded a great deal of helpful information about differences in gene expression associated with levels of disease activity.2 These earlier studies had only been able to sample sparsely—every three months or less frequently. Dr. Orange points out that with such data sets, it’s difficult to look at flares in a granular way. The researchers attempted to collect a much greater swath of data, hoping to look at differences in genetic expression that might be occurring just prior to flare.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Longitudinal RNA Sequencing Analysis

The study authors used RNA sequencing to identify patterns of gene expression from one index patient with rheumatoid arthritis. Self-administered fingerstick blood specimens from 364 time points encompassed eight flares over four years. They eventually added information from an additional 235 time points from three more rheumatoid arthritis patients.

The patients assessed their disease activity using the Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire, which compiles scores of patient-perceived pain, functional impairment and a global health impression. Physician assessments of disease activity were also performed at monthly clinic visits using both RAPID3 and the Disease Activity Score 28 (DAS28), as well as with standard blood count tests.

First, the team looked at gene expression differences between baseline and flare. They noticed an increase in the expression of genes related to inflammation during the flare, such as those reflecting an increased white blood cell count, which corresponded to flares as assessed by the patient (via the RAPID3).

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 5 | Single Page

Filed Under: Conditions, Research Reviews, Rheumatoid Arthritis Tagged With: Flares, geneticsIssue: December 2020

You Might Also Like:
  • Synovial Analysis Identifies Distinct Rheumatoid Arthritis Subtypes
  • Survivin Essential for the Maturation of Antigen Presenting Cells in Rheumatoid Arthritis Patients
  • The Role of Autoreactive B Cells in Rheumatoid Arthritis
  • Study Finds Correlations Between Synovial Tissue & Gene Expression

About Ruth Jessen Hickman, MD

Ruth Jessen Hickman, MD, was born and raised in eastern Kentucky, where she first cultivated her love of literature, writing and personal narratives. She attended Kenyon college, where she received a Bachelor of Arts in philosophy, summa cum laude. She worked with individuals with psychiatric conditions and later in a neuroscience lab at the University of Illinois, Chicago, before graduating from Indiana University Medical School in 2011. Instead of pursuing clinical medicine, Ruth opted to build on her strength of clearly explaining medical topics though a career as a freelance medical writer, writing both for lay people and for health professionals. She writes across the biomedical sciences, but holds strong interests in rheumatology, neurology, autoimmune diseases, genetics, and the intersection of broader social, cultural and emotional contexts with biomedical topics. Ruth now lives in Bloomington, Ind., with her husband, son and cat. She can be contacted via her website at www.ruthjhickmanmd.com.

View more by this author»

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.