AB0049 IMMUNE DYSFUNCTION IN ANKYLOSING SPONDYLITIS (AS) AND THE POTENTIAL OF TUMOR NECROSIS FACTOR-Α (TNF-α) INHIBITOR ANBAINUO AS AN EFFECTIVE TREATMENT
Authors: M. Yang, Q. Lv, Q. Wei, J. Gu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Studies into ankylosing spondylitis (AS) and its relationship with immune function are controversial, and the correlation between the efficacy of TNF-α inhibitor and changes in immune function is unclear. Objectives: We conducted a prospective study of T-cell and B-cell subset distribution and analyzed lymphocyte function in AS patients to further clarify changes to the immune system caused by AS and to explore resistance that could contribute to relapse after treatment. Methods: A total of 40 immune cells were tested with flow cytometry, and the results of 105 HC (healthy control) subjects, 177 active-stage AS patients, and 23 AS cases before and after 12 weeks of Anbainuo therapy were analyzed. Results: Compared with the HC group, the proportion of immune cells, such as naïve and central memory CD4+T cells, in AS increased (p&lt;0.0001), but effector memory and terminally differentiated CD4+T cells were decreased (p&lt;0.01 and 0.0001, respectively). Naïve, central memory, and effector memory CD8+T cells were increased (p&lt;0.0001, 0.001, and 0.01, respectively), but terminally differentiated CD8+T cells were decreased (p&lt;0.0001). Th1 cells (helper T cells-1), Tfh1 cells (follicular helper T cells-1), Tc1 cells (cytotoxic T cells-1), and Tregs (regulatory T cells) were lower (p&lt;0.01, 0.05, 0.0001, and 0.001, respectively), but Th17 cells, Tfh17 cells, and Tc cells were higher (p&lt;0.001, 0.0001 and 0.001, respectively). The proportions of total B cells and class-switched B cells were increased (p&lt;0.05), but non-switched B cells, plasma cells, memory B cells, and immature Bregs (regulatory B cells) were lower (p&lt;0.01, 0.0001, 0.0001, and 0.0001, respectively). After Anbainuo therapy, the percentage of Tregs and B10 cells (IL-10-producing regulatory B cells) had increased (p&lt;0.01and 0.05, respectively), and the increase in Tregs was positively correlated with the decrease in CRP (C-reactive protein) (r= 0.489, p=0.018). Conclusion: We found that, in terms of both innate and acquired immunity, active-stage AS patients have an immunity imbalance involving multiple types of immune cells, including CD4+T cells, CD8+T cells, Th cells, Tfh cells, Tc cells, Tregs, Bregs, and B cells. Anbainuo can not only help to inhibit disease activity and partial immune function imbalance in AS but can also increase the number of negative regulatory cells in inflammation. References: [1]Long, S., et al., High frequency of circulating follicular helper T cells is correlated with B cell subtypes in patients with ankylosing spondylitis. Exp Ther Med, 2018. 15(5): p. 4578-4586. [2]An, H., et al., The absolute counts of peripheral T lymphocyte subsets in patient with ankylosing spondylitis and the effect of low-dose interleukin-2. Medicine (Baltimore), 2019. 98(15): p. e15094. Acknowledgments: Thanks to Professor Zhinan Yin for his support and assistance with this study Disclosure of Interests: None declared