Cell detectives offer clues to counter rheumatoid arthritis flare-ups 

Dendritic cells, which process information about other cells and can activate or deactivate immune cells, behave differently in the bodies of sufferers likely to endure post-treatment flare-ups, report researchers writing in Immunity. 

This could provide an early prediuctor of those likely to be affected by subsequent problems, suggest the University of Glasgow scientists who led the study that included several fellow institutions taking part in the ‘Versus Arthritis’ project  conducted by RACE – the Research into Inflammatory Arthritis Centre.

Employing new spatial transcriptomics techniques to analyse tissue from the joints of sufferers, they were able to locate individual cell locations.

To carry out the study, the research team examined the joints of rheumatoid arthritis patients, analysing their tissue using the novel technique spatial transcriptomics, which allows for the precise identification of cell locations

This revealed that those patients likely to experience flare-ups had dendritic cells present in their blood stream weeks before they had any awareness of the disease outbreak. 

Of the 450,000 adults in the UK that have rheumatoid arthritis – themselves part of the 1% of the world’s population who are sufferers – it is estimated 50% of those finishing treatment courses will experience flareups months or just weeks afterwards.

In patients who do not suffer flare-ups, dendritic cells suppress the body’s immune or T-cells. Yet, in those whose arthritis is active, dendritic cells migrate from blood to joints, instructing T-cells to attack.

The researchers hope their findings can pave the way to find new treatments that target dendritic cells before flare-ups occur, allowing more people with rheumatoid arthritis to remain in remission.

Senior author of the study professor Mariola Kurowska-Stolarska, of the University of Glasgow, said: “Recent advancements in technology allow us to examine tissue at high resolution, identifying specific cell-to-cell interactions that cause pathology. This helps to pinpoint the cause of diseases, such as flare-ups, before they begin.”

The study was a collaboration between Glasgow and the universities of Newcastle, Birmingham and Oxford, together with Rome’s Universitario A. Gemelli IRCCS. Funding was supplied by Versus Arthritis along with grants from the Wellcome Trust and the Italian Ministry of Health

Dr Caroline Aylott, head of research delivery at Versus Arthritis, said: "By using this new technology, researchers are able to look in more detail than ever before at the cells responsible for inflammation in the joint. This means we are closer to using these as markers to predict when painful flare-ups will occur, which will help people to manage their rheumatoid arthritis better.  

Pic: Anna Shvets

Distinct Tissue-Niche Localization and Function of Synovial Tissue Myeloid DC Subsets in Health, and in Active and Remission Rheumatoid Arthritis