Scientists from the Hospital for Special Surgery (HSS) and collaborating institutions have identified distinct immune cell patterns in blood that could signal an increased risk of developing rheumatoid arthritis (RA) before symptoms arise. The breakthrough, unveiled at the annual American College of Rheumatology (ACR) Convergence 2024 meeting, marks a significant step toward the development of a blood test to identify patients at higher risk of the disease.
The study, led by researchers from the University of Colorado School of Medicine in collaboration with HSS and other institutions within the Accelerating Medicines Partnership® Program for Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP® RA/SLE) Network, used advanced single-cell sequencing to analyze blood and tissue samples from patients at various stages of RA risk.
Key findings included elevated levels of immune cells such as CCR2+ T helper cells, T peripheral helper cells, and granzyme B-positive memory T helper cells in individuals at risk for RA. These cells were also linked to specific activated genes, shedding light on the underlying biology of the disease’s progression.
“These research findings validate the importance of certain immune cells in the development of RA, particularly in how they drive the change from asymptomatic to symptomatic,” said Dr. Laura Donlin, co-director of the HSS Precision Medicine Program and co-principal investigator of the AMP Rheumatoid Arthritis research consortium. “We hope that one day we can use these insights to stop RA before it even begins.”
Rheumatoid arthritis is a chronic inflammatory condition in which immune cells attack healthy tissues, causing joint pain, swelling, and stiffness. The disease can also affect other organs, including the heart and lungs. Diagnosis traditionally requires clinical evaluation and imaging supported by blood tests, but the new findings could revolutionize early detection and intervention.
The research focused on individuals with antibodies known as ACPA, a biomarker for RA, who also had a first-degree relative with the condition. Blood samples from these individuals were compared to those from RA patients and healthy controls, providing critical insights into immune system differences.
Dr. Susan M. Goodman, a rheumatologist at HSS and co-author of the study, emphasized the importance of the findings. “We knew that the presence of ACPA and a family history indicate risk, but this research offers a deeper understanding of the biology behind that risk. It opens the door to new tools for identifying individuals who may benefit from early intervention.”
Existing RA treatments, such as abatacept and rituximab, have shown potential in delaying disease onset, but their high costs and side effects limit preventive use. The newly identified immune cell patterns could guide the development of targeted therapies with fewer drawbacks, said Dr. S. Louis Bridges, Jr., physician-in-chief at HSS.
Pending validation in larger studies, the findings represent a major advancement in RA research, with implications for early detection and improved patient outcomes. Researchers are optimistic that the study will pave the way for more effective strategies to combat a disease that affects millions worldwide.
The work highlights the growing role of precision medicine in rheumatology, offering hope for early intervention in autoimmune diseases. For more information, visit HSS.edu.
