AB0504 THE DIFFERENCES OF IMMUNE CHARACTERISTICS AND ITS RELATIONSHIP WITH DISEASE ACTIVITY IN LARGE VESSEL VASCULITIS PATIENTS
Authors: A. Maimaitiyakefu, L. Wu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Large vessel vasculitis(LVV) is a rare refractory disease, giant cell arteritis (GCA) and Takayasu arteritis (TAK) constitute different types of primary LVV.Despite considerable discussion on the potential differences between GCA and TAK, the immunological difference and its relationship to disease activity remains unclear. Objectives: To investigate the differences of peripheral blood immuno-phenotype between TAK and GCA, and to analyze the correlation between immune metabolism level and disease activity in TAK. Methods: All patients with TAK and GCA who come to our department from January 2010 to January 2020 were included, all of them met the classification criteria of American college of rheumatology.General information, clinical manifestations, laboratory index, artery involvement and therapeutic schedule were collected.According to the National Institutes of Health criteria, there were 29 active and 23 inactive TAK patients. Results: [1]Baseline characteristics, treatment,involvement artery in LVV patients are summarized in Table 1. Table 1. Clinical characteristics of patients with LVV Variable TAK,n=52 GCA,n=4 Age,X±S 29±13 64±7 Female,n(%) 45(86.6) 1(25) Constitutional symptoms,n(%) 23 (43.4) 3(75) Cephalic symptoms,n(%) 33 (62.3) 2 (50) Peripheral limb ischemia,n(%) 22 (41.5) - Ocular signs,n(%) 3 (5.7) 2 (50) Stroke,n(%) 2 (3.8) - GC,n(%) 40(76.9) 3(75) GC dose &gt;7.5mg/day,n(%) 36 (90) 2 (66.7) Surgical intervention,n(%) 7(13.2) - Coronary artery,n(%) 3(5.7) - Common carotid artery,n(%) 31(58.5) - Subclavian artery,n(%) 23(43.4) - thoracic aorta,n(%) 6(11.3) - abdominal aorta,n(%) 13(24.5) - GC Glucocorticoids,bDMARDS biologic DMARDs (2)Compared with GCA patients,TAK patients were younger (29±13vs64±7,P=0.015), with higher peripheral blood lymphocyte count of CD8+T cells and lower CD4/CD8(Table 2). Table 2. Comparison of peripheral immune cells,humoral immunity among TAK and GCA,active and inactive TAK Variable TAK,n=52 GCA,n=4 p value inactive TAK,n=23 active TAK,n=29 p value Neutrophils 5.5±2.3 5.8±1.1 0.827 4.4±1.6 6.3±2.5 0.009 * Lymphocytes 2.4±0.8 1.0±0.6 0.010 * 2.3±0.7 2.4±0.9 0.901 Monocytes 0.5±0.2 0.7±0.1 0.218 0.5±0.2 0.6±0.2 0.431 CD3 + T 1959±490 1154±541 0.189 2195±92 1842±585 0.467 CD4 + T 1074±305 758±303 0.381 1250±198 987±333 0.376 CD8 + T 859±212 297±87 0.048 * 945±41 815±258 0.542 CD4 + CD8 + 42±27 12±7 0.344 63±2 32±28 0.229 CD4-CD8- 90±75 91±63 0.999 97±74 87±68 0.914 CD19 + B 273±97 191±94 0.470 202±106 309±84 0.242 CD16 + CD56 + 135±72 104±67 0.709 112±63 146±83 0.639 CD4/CD8 1.25±0.15 2.55±0.51 0.001 * 1.33±0.26 1.21±0.10 0.440 IgG 11.7±3.7 8.3±0.5 0.124 10.3±3.4 12.9±3.6 0.025 * IgA 2.6±1.3 2.3±0.8 0.724 2.1±1.3 3.0±1.1 0.021 * IgM 1.7±0.9 0.8±0.2 0.118 1.5±0.8 1.8±0.9 0.202 Κ light chain 9.5±3.9 6.6±0.3 0.222 8.1±3.3 10.8±4.0 0.033 * λ light chain 5.2±1.9 3.9±0.3 0.260 4.7±1.9 5.8±1.9 0.086 * P&lt;0.05 (3)The levels of neutrophils, monocytes,IgG, IgA and Κ light chain active TAK were higer than inactive TAK, with lower lymphocyte level (Table 2). Further correlation analysis showed that the levels of neutrophils, IgG,IgA and Κ light chain were positively correlated with disease activity (r=0.434,P=0.005;r=0.380,P=0.019;r=0.452,P=0.004;r=0.380,P=0.022). Conclusion: Compared with GCA patients,TAK patients had higer level of CD8 + T lymphocytes, consistenting with previous studies.In addition,TAK patients had persistent immune cell involvement,while humoral immunity is related to disease activity.Deeper studies may be required about the role of immune profile in in large vessel vasculitis. References: [1]Miyabe C, Miyabe Y, et al. An expanded population of pathogenic regulatory T-cells in giant cell arteritis is abrogated by IL-6 blockade therapy. Ann Rheum Dis. 2017;76:898–905. [2]Kermani TA, Crowson CS, Muratore F, Schmidt J, Matteson EL, Warrington KJ. Extra-cranial giant cell arteritis and Takayasu arteritis: how similar are they? Semin Arthritis Rheum. 2015;44:724–8. Disclosure of Interests: None declared