There may be a significant association between clinical characteristics and changes in the immunophenotype in patients with primary large vessel vasculitis (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TAK), according to study results published in Arthritis Research & Therapy.

The study included a cohort of consecutive patients with newly diagnosed LVV (n=20) between May 2016 and May 2019. Researchers collected data on the number of circulating T cells, B cells, natural killer cells, dendritic cells, monocytes, and granulocytes. They then assessed baseline and time-course changes in immunophenotyping associated with disease activity.

Researchers identified 90 samples from 20 patients, which were compared with data samples from healthy controls. Of the 20 patients with LVV, 12 had GCA and 8 had TAK. Compared with healthy controls, patients with GCA and TAK had higher numbers of helper T (Th) cells, follicular helper T (Tfh) cells, CD8+ T, CD14++ CD16+ monocytes, and neutrophils. Compared with patients with GCA, patients with TAK had higher numbers of CD8+ T and CD8+ Tem cells. In addition, patients with TAK had high levels of memory CD4+ and CD8+ T cells, even during the remission phase.

After further analysis, the researchers found that the number of Th1, Th17, and Tfh cells was associated with disease relapse in GCA and TAK. The number of CD8+ T cells was also associated with relapse in patients with TAK.


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Treatment with biologic agents resulted in a decrease of Th1, Th17, and Tfh cells, but it did not affect CD8+ T cell number, which could suggest that new treatment to target CD8+ T cells may be warranted.

Study limitations included the small sample size, the short observation period, and that the types of immune cells affecting the tissues were not determined.

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“Accumulation of further evidence on immuno-phenotype profiles is expected to improve treatment options for [patients with] LVV,” the researchers wrote.

Disclosure: This clinical trial was supported by the Mitsubishi Tanabe Pharma Corporation. Please see the original reference for a full list of authors’ disclosures.

Reference

Matsumoto K, Suzuki K, Yoshimoto K, et al. Significant association between clinical characteristics and changes in peripheral immune-phenotype in large vessel vasculitis. [published online December 30, 2019]. Arthritis Res Ther. doi:10.1186/s13075-019-2068-7