| Citation: |
LI Zhengfang, WU Chanyuan, MA Mengsi, LI Tingting, WU Xue, MENG Xinyan, ZHANG Sha, WU Lijun. Clinical and Immunological Characteristics of Elderly Onset Rheumatoid Arthritis[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(1): 59-64. DOI: 10.12290/xhyxzz.2024-0904
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To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients.
The patients with rheumatoid arthritis (RA) who were hospitalized in the Department of Rheumatology and Immunology of the People's Hospital of Xinjiang Uygur Autonomous Region from March 2023 to December 2023 were selected as the study objects. The demographic data, clinical characteristics, extra-articular manifestations and laboratory examination results of the patients were collected. The patients were divided into EORA group and young adult (< 60 years old)onset rheumatoid arthritis (YORA) group, and the clinical features and peripheral blood immunological indexes of the two groups were compared.
A total of 187 RA patients with an average age of (62.1±12.0) years were enrolled, including 89 patients in the EORA group and 98 patients in the YORA group. Compared with YORA group, EORA group had a higher proportion of male patients(39.3% vs. 22.4%, P=0.012), patients with interstitial lung disease (21.4% vs. 3.1%, P < 0.001), and patients with anemia (10.1% vs. 3.1%, P=0.049).The onset of large joint was more common in the EORA group(53.9% vs. 23.5%, P < 0.001). The number of joint swelling [6(2, 11) vs. 3(1, 7), P=0.002], and the number of tenderness [8(4, 13) vs. 5(3, 9), P=0.001] were also higher in the EORA group. Greater inflammation [C-reactive protein(CRP) : 12.3(3.9, 33.2)mg/L vs. 5.5(1.8, 16.9)mg/L, P=0.000; erythrocyte sedimentation rate(ESR) : 30.5(15.0, 63.0)mm/h vs. 19.0(8.0, 41.0)mm/h, P= 0.006], higher DAS28-CRP score [4.0(2.7, 5.0) vs. 3.2(2.4, 4.9), P=0.002] and DAS28-ESR score [4.3 (2.8, 5.3) vs. 3.4 (2.1, 4.7), P=0.001] were also observed. In terms of peripheral blood immune indexes, the proportion of CD4+T cells in EORA group [(44.5±10.6)% vs. (48.8±10.7)%, P=0.045] was lower than that in YORA group, while the proportion of NK cells [(14.8±8.9)% vs. (10.1±3.7)%, P=0.003] and absolute count [(230.2±156.7)PCS/μL vs. (155.9±106.5)PCS/μL, P=0.014] in EORA group were higher than those in YORA group.
Compared with YORA, EORA has higher male proportion, joint disease degree and disease activity. EORA is prone to interstitial lung disease, anemia and high inflammation, and the level of peripheral blood NK cells is higher.
| [1] |
Smolen J S, Aletaha D, McInnes I B. Rheumatoid arthritis[J]. Lancet, 2016, 388(10055): 2023-2038. DOI: 10.1016/S0140-6736(16)30173-8
|
| [2] |
国家统计局. 中国统计年鉴2022[M]. 北京: 中国统计出版社, 2022.
National Bureau of Statistics. China statistical yearbook 2022[M]. Beijing: China Statistics Press, 2022.
|
| [3] |
Tan T C, Gao X, Thong B Y H, et al. Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort[J]. Int J Rheum Dis, 2017, 20(6): 737-745. DOI: 10.1111/1756-185X.12861
|
| [4] |
Pérez N, De Los Ángeles Gargiulo M, Khoury M, et al. Elderly-onset rheumatoid arthritis receives less aggressive therapies than young-onset rheumatoid arthritis in an Argentinian cohort[J]. Reumatol Clin(Engl Ed), 2024, 20(3): 136-141. DOI: 10.1016/j.reuma.2023.10.004
|
| [5] |
单颖, 姜东, 李淑云, 等. 老年人T细胞亚群的Meta分析[J]. 中国老年学杂志, 2007, 27(19): 1905-1907. DOI: 10.3969/j.issn.1005-9202.2007.19.024
Shan Y, Jiang D, Li S Y, et al. Meta analysis of T cell subsets in elderly individuals[J]. Chin J Gerontol, 2007, 27(19): 1905-1907. DOI: 10.3969/j.issn.1005-9202.2007.19.024
|
| [6] |
Lindstrom T M, Robinson W H. Rheumatoid arthritis: a role for immunosenescence?[J]. J Am Geriatr Soc, 2010, 58(8): 1565-1575. DOI: 10.1111/j.1532-5415.2010.02965.x
|
| [7] |
Kay J, Upchurch K S. ACR/EULAR 2010 rheumatoid arthritis classification criteria[J]. Rheumatology(Oxford), 2012, 51(S6): vi5-vi9.
|
| [8] |
Safiri S, Kolahi A A, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990—2017: a systematic analysis of the Global Burden of Disease study 2017[J]. Ann Rheum Dis, 2019, 78(11): 1463-1471. DOI: 10.1136/annrheumdis-2019-215920
|
| [9] |
Yazici Y, Paget S A. Elderly-onset rheumatoid arthritis[J]. Rheum Dis Clin North Am, 2000, 26(3): 517-526. DOI: 10.1016/S0889-857X(05)70154-X
|
| [10] |
Maassen J M, Bergstra S A, Chopra A, et al. Phenotype and treatment of elderly onset compared with younger onset rheumatoid arthritis patients in international daily practice[J]. Rheumatology(Oxford), 2021, 60(10): 4801-4810. DOI: 10.1093/rheumatology/keab102
|
| [11] |
张警丰, 叶修玲, 段萌, 等. 老年与青壮年发病类风湿关节炎的临床特点比较[J]. 中华医学杂志, 2020, 100(47): 3788-3792. DOI: 10.3760/cma.j.cn112137-20200506-01439
Zhang J F, Ye X L, Duan M, et al. Clinical characteristics of elderly and younger onset rheumatoid arthritis[J]. Natl Med J China, 2020, 100(47): 3788-3792. DOI: 10.3760/cma.j.cn112137-20200506-01439
|
| [12] |
孙驰, 董晨, 毛雪, 等. 老年与非老年类风湿关节炎患者外周血中淋巴细胞亚群的差异性及其临床意义[J]. 中华老年医学杂志, 2023, 42(1): 46-51. DOI: 10.3760/cma.j.issn.0254-9026.2023.01.009
Sun C, Dong C, Mao X, et al. Difference and its clinical significance of peripheral blood lymphocyte subsets between elderly and non-elderly patients with rheumatoid arthritis[J]. Chin J Geriatr, 2023, 42(1): 46-51. DOI: 10.3760/cma.j.issn.0254-9026.2023.01.009
|
| [13] |
Pavlov-Dolijanovic S, Bogojevic M, Nozica-Radulovic T, et al. Elderly-onset rheumatoid arthritis: characteristics and treatment options[J]. Medicina(Kaunas), 2023, 59(10): 1878. http://www.mdpi.com/1648-9144/59/10/1878#metrics
|
| [14] |
Romão V C, Humby F, Kelly S, et al. Treatment-resistant synovitis and radiographic progression are increased in elderly-onset rheumatoid arthritis patients: findings from a prospective observational longitudinal early arthritis cohort study[J]. Semin Arthritis Rheum, 2020, 50(4): 735-743. DOI: 10.1016/j.semarthrit.2020.03.018
|
| [15] |
王子韬, 向婷, 王文, 等. 老年类风湿关节炎患者实验室检查及共病的特点分析[J]. 中华老年医学杂志, 2022, 41(4): 411-416. DOI: 10.3760/cma.j.issn.0254-9026.2022.04.010
Wang Z T, Xiang T, Wang W, et al. The characteristics of laboratory findings and multimorbidities in elderly patients with rheumatoid arthritis[J]. Chin J Geriatr, 2022, 41(4): 411-416. DOI: 10.3760/cma.j.issn.0254-9026.2022.04.010
|
| [16] |
Messina R, Guggino G, Benfante A, et al. Interstitial lung disease in elderly rheumatoid arthritis patients[J]. Drugs Aging, 2020, 37(1): 11-18. DOI: 10.1007/s40266-019-00727-z
|
| [17] |
Qin L, Jing X, Qiu Z F, et al. Aging of immune system: immune signature from peripheral blood lymphocyte subsets in 1068 healthy adults[J]. Aging(Albany NY), 2016, 8(5): 848-859. http://archive.impactaging.com/papers/v8/n5/pdf/100894.pdf
|
| [18] |
Yousefzadeh M J, Flores R R, Zhu Y, et al. An aged immune system drives senescence and ageing of solid organs[J]. Nature, 2021, 594(7861): 100-105. DOI: 10.1038/s41586-021-03547-7
|
| [19] |
田佳宜, 郭一学, 张霞, 等. 中国健康成人外周血自然杀伤细胞及其亚群的正常值范围流式细胞学分析[J]. 北京大学学报(医学版), 2024, 56(5): 839-844.
Tian J Y, Guo Y X, Zhang X, et al. Flow cytometry analysis of normal range of natural killer cells and their subsets in peripheral blood of healthy Chinese adults[J]. J Peking Univ(Health Sci), 2024, 56(5): 839-844.
|
| [20] |
Kim H Y, Kim H J, Min H S, et al. NKT cells promote antibody-induced joint inflammation by suppressing transform-ing growth factor beta1 production[J]. J Exp Med, 2005, 201(1): 41-47. DOI: 10.1084/jem.20041400
|
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