Expansion of CD4+CD28null T Lymphocytes Contributes to Coronary Artery Diseases in Rheumatoid Arthritis Patients

[摘要] Background: The expanded CD4+ clonotype T cell subset lacking surface CD28 has been suggested to predispose rheumatoid arthritis (RA)patients to develop more aggressive disease including extra-articular manifestations and CAD. Patients and Methods: The number of circulatingCD4+CD28null T cells was evaluated in 42 RA and 10 control subjects by 2-color FACSort flow cytometer, patients underwent evaluation ofjoint involvement, extra-articular manifestations, and CAD association. Results: The frequency of CD4+CD28null cells was significantly higherin patients than in control subjects. RA patients with persistent expansion of circulating CD4+CD28null cells had more marked increase of extraarticularmanifestation (P = 0.000) and CAD (P = 0.000). Expansion of circulating CD4+CD28null T cells correlated significantly withelevated ESR, triglycerides, and seronegative RF. Conclusion: Circulating CD4+CD28null T lymphocytes are increased in RA. Patients withpersistent CD4+CD28null T cell expansion show more extra-articular manifestation and CAD. These findings suggest that increasedCD4+CD28null T cell expansion, ESR, and triglyceride levels together with seronegative RF can serve as markers to help identify patients withrheumatoid arthritis who are at risk of developing CAD. Moreover, the correlation between CD4+CD28null T cell expansion, ESR, andtriglyceride levels together with seronegative RF may be of interest for possible innovative predictive and diagnostic strategies in cardiovasculardiseases.

[学科分类] 心脏病和心血管学

[关键词] CAD;CD28null;CD4+;extra-articular manifestation;RA