Association of anticytomegalovirus seropositivity with more severe joint destruction and more frequent joint surgery in rheumatoid arthritis

作者：Pierer Matthias; Rothe Kathrin; Quandt Dagmar; Schulz Anett; Rossol Manuela; Scholz Roger; Baerwald Christoph; Wagner Ulf^*

来源：Arthritis and Rheumatism, 2012, 64(6): 1740-1749.

DOI：10.1002/art.34346

Objective Expansion of autoreactive CD4+CD28null T cells is associated with extraarticular disease manifestations, including rheumatoid vasculitis, and it has recently been demonstrated that expansion of these T cells is associated with anticytomegalovirus (anti-CMV) seropositivity. This study was undertaken to investigate a possible link between latent CMV infection and rheumatoid arthritis (RA). Methods In a retrospective analysis, anti-CMV antibodies and clinical, serologic, and radiologic parameters of joint destruction were examined in 202 RA patients and 272 healthy controls. In addition, frequencies of CD4+CD28null T cells; concentrations of the cytokines monocyte chemotactic protein 1 (MCP-1), interferon-a (IFNa), and IFN-inducible protein 10; and anti-CMVspecific T cell responses were analyzed in RA patients. Results Overall, no significant difference in the frequency of anti-CMV seropositivity between RA patients and healthy controls was observed. Among individuals older than age 55 years, however, anti-CMV IgG antibodies were significantly more frequent in RA patients than controls (65.3% and 54.7%, respectively; P = 0.05). Anti-CMV seropositivity in RA patients was associated with an increased frequency of CD4+CD28null T cells and increased serum concentrations of MCP-1. The frequency of anti-CMVspecific CD4+ T cells producing IFN? was increased in RA patients compared to controls. Most importantly, anti-CMVseropositive RA patients showed radiographic evidence of more advanced joint destruction and had increased frequencies of joint-related surgical procedures, indicating more severe joint disease. Conclusion Our findings indicate that latent CMV infection aggravates the clinical course of RA and is associated with increased frequencies of CD4+CD28null T cells and of CMV-specific IFN?-secreting CD4+ T cells.

• 出版日期2012-6