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The study will reveal the transcriptomic signature linked to the aberrant activation of B lymphocytes in RA identifying novel molecular potential targets for inflammation resolution and immune tolerance promotion. The combination with B lymphocytes phenotyping will dissect the impact of the identified genes on B lymphocyte maturation and activation in RA. Moreover, in vitro study on B lymphocyte cultures using selective JAK1 inhibition will reveal, at deeper level, its transcriptomic effect on RA B lymphocytes activation profile and phenotype, providing the discovery of new biomarkers of the loss of immunological tolerance, active disease and long lasting disease remission.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ACPA/RFpos asyntomatic individuals | ACPA and/or RF positive individuals without active arthritis |
| |
| Naive Active RA | Treatment-naive active RA (disease duration<1 year) |
| |
| Resistant RA | Active despite treatment RA |
| |
| Remission RA | RA in sustained clinical and ultrasound remission |
| |
| Control Group | Individuals asymptomatic for joint inflammation without ACPA/RF positivity |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| B lymphocyte profiling | Other | All individuals will undergo peripheral venous blood sampling and ultrasound-guided synovial tissue biopsy following a standardized procedure. B-lymphocytes will be sorted from PBMCs isolated by Ficoll gradient method using magnetic CD19-microbeads whereas tissue B-lymphocytes will be isolated from synovial tissue biopsies digested with Liberase. CD19 positive cells from PBMC will be incubated with pro-inflammatory molecules in presence or absence of Ubadacitinib. After stimulation, CD19 positive cells will be collected and processed for single cell RNA sequencing. Moreover, the impact of JAK-1 selective inhibition on B-lymphocyte cultures stimulation will be tested using ELISA method for the assessment of cytokines/chemokines production. Synovial tissue and synovial tissue B-lymphocyte subpopulations will be assessed through FACS analysis using IgD/CD27 classification. Finally, we will compare the transcriptomic profile of synovial tissue B lymphocytes from 5 subject groups. |
| Measure | Description | Time Frame |
|---|---|---|
| Peripheral blood and synovial tissue B lymphocyte atlas | 24 months |
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Inclusion Criteria:
Exclusion Criteria:
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This is an interventional research without experimental drug which will be performed at the Division of Clinical Immunology of the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome, Italy, where patients with Rheumatoid Arthritis will undergo to synovial tissue inflammation assessment through minimally invasive US-guided synovial tissue biopsy.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Elisa Gremese | Contact | 00390630159659 | elisa.gremese@policlinicogemelli.it |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli-IRCCS | Recruiting | Rome | 00168 | Italy |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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|
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |