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Rheumatoid pericarditis: new immunopathological aspects
A Travaglio-Encinoza1, J M Anaya, A D Dupuy D'Angeac
1INSERM U-291, Hôpital Gui de Chauliac, Montpellier, France.
Abstract:
Rheumatoid pericarditis (RP) is a well known extraarticular manifestation of rheumatoid arthritis (RA). It is not frequently diagnosed despite its high reported prevalence in post-mortem studies. There have been no immunohistological studies of its presence in pericardial membranes. Here we report a complete immunohistological study of two RA patients with RP complications, using a panel of monoclonal antibodies (mAbs) for the recognition of B, T, and NK cells. Both cases showed strong and almost exclusive pericardial membrane infiltration of CD8+ T-cells which was correlated with a higher than expected similar increase in the subset of peripheral blood lymphocytes (PBL). These findings suggest an important role for CD8+ T-cells in chronic RA, especially in this extraarticular manifestation of the disease.
Insights
Rheumatoid pericarditis (RP), an RA complication, involves CD8+ T-cell infiltration in the pericardial membrane. This finding highlights the significant role of CD8+ T-cells in rheumatoid arthritis extraarticular manifestations.
Area of Science:
- Immunology
- Rheumatology
- Pathology
Background:
- Rheumatoid pericarditis (RP) is a recognized extraarticular manifestation of rheumatoid arthritis (RA).
- RP is often underdiagnosed clinically, despite high prevalence noted in post-mortem analyses.
- Immunohistological data on RP in pericardial membranes remain scarce.
Observation:
- This study presents a comprehensive immunohistological analysis of pericardial membranes from two RA patients with RP.
- A panel of monoclonal antibodies was utilized to identify B, T, and NK cell populations.
- Both cases exhibited pronounced infiltration of CD8+ T-cells within the pericardial membranes.
Findings:
- Pericardial membranes in rheumatoid pericarditis showed a strong and near-exclusive infiltration by CD8+ T-cells.
- A concurrent increase in peripheral blood lymphocytes (PBL), specifically the CD8+ subset, was observed.
- These findings indicate a significant role for CD8+ T-cells in the pathogenesis of chronic RA and its pericardial manifestation.
Implications:
- The study underscores the critical involvement of CD8+ T-cells in rheumatoid arthritis pathogenesis, particularly in extraarticular disease.
- Results suggest potential diagnostic or therapeutic targets related to CD8+ T-cell activity in RA patients with cardiac involvement.
- Further research into the specific mechanisms of CD8+ T-cell recruitment and function in RP is warranted.