Objective We examined gene expression profiles in peripheral blood leukocytes (PBL) of patients with osteoarthritis (OA) in comparison with non-OA controls to evaluate whether gene expression profiles could serve as biomarkers of symptomatic knee OA. We also determined whether candidate genomic biomarkers (PBL expression of inflammatory genes) predict increased risk of disease progression in subjects with symptomatic radiographic knee OA Methods Three independent cohorts of patients with knee OA and non-OA controls were studied: two cohorts (“learning cohort” and “validation cohort”) recruited at New York University Hospital for Joint Diseases (NYUHJD) and one (“validation cohort”) at Duke University Medical Center. PBL gene expression was assessed using Affymetrix microarray and confirmed by QPCR. Radiographic progression at 2 years was assessed in 86 patients Results We identified 173 genes significantly up- or down-regulated (≥1.5-fold change) in OA PBL, at a False Discovery Rate (FDR) of 5%. Cluster analysis revealed two distinct subclasses among these OA patients: those with increased expression (≥2-fold) of IL-1β compared to controls, and those with expression comparable to controls. Overexpression of IL-1β in OA subclasses was validated using QPCR (p<0.0001) in all three cohorts. Patients with the inflammatory “IL-1β signature” had higher pain scores, decreased function and were at higher risk for radiographic progression. Conclusion PBLs from patients with symptomatic knee OA display a characteristic transcriptome profile. Moreover, increased expression of IL-1β identifies a subset of OA patients with increased pain who are at higher risk for radiographic progression.

Background Patients with systemic lupus erythematosus (SLE) are at risk of developing COVID-19 due to underlying immune abnormalities and regular use of immunosuppressant medications. We aimed to evaluate the presence of SARS-CoV-2 IgG antibodies in patients with SLE with or without previous COVID-19-related symptoms or RT-PCR-confirmed SARS-CoV-2 infection. Methods For this analysis, we included patients with SLE from two cohorts based in New York City: the Web-based Assessment of Autoimmune, Immune-Mediated and Rheumatic Patients during the COVID-19 pandemic (WARCOV) study; and the NYU Lupus Cohort (a prospective registry of patients at NYU Langone Health and NYC Health + Hospitals/Bellevue). Patients in both cohorts were tested for SARS-CoV-2 IgG antibodies via commercially available immunoassays, processed through hospital or outpatient laboratories. Patients recruited from the NYU Lupus Cohort, referred from affiliated providers, or admitted to hospital with COVID-19 were tested for SARS-CoV-2 IgG antibodies as part of routine surveillance during follow-up clinical visits. Findings 329 patients with SLE were included in this analysis, 146 from the WARCOV study and 183 from the NYU Lupus Cohort, and were tested for SARS-CoV-2 antibodies between April 29, 2020, and Feb 9, 2021. 309 (94%) were women and 91 (28%) were of Hispanic ethnicity. 51 (16%) of 329 patients had a positive SARS-CoV-2 IgG antibody test. Seropositive patients were more likely than seronegative patients to be Hispanic (24 [47%] of 51 vs 67 [24%] of 278). Other demographic variables, SLE-specific factors, and immunosuppressant use were not associated with SARS-CoV-2 positivity. Of the 29 patients with COVID-19 previously confirmed by RT-PCR, 18 (62%) were on immunosuppressants; 24 (83%) of 29 patients tested positive for SARS-CoV-2 IgG antibodies. Of 17 patients who had symptoms of COVID-19 but negative concurrent RT-PCR testing, one (6%) developed an antibody response. Of 26 patients who had COVID-19-related symptoms but did not undergo RT-PCR testing, six (23%) developed an antibody response. Of 83 patients who had no symptoms of COVID-19 and no RT-PCR testing, four (5%) developed an antibody response. Among 36 patients who were initially SARS-CoV-2 IgG positive, the majority maintained reactivity serially (88% up to 10 weeks, 83% up to 20 weeks, and 80% up to 30 weeks). Seven (70%) of ten patients with confirmed COVID-19 had antibody positivity beyond 30 weeks from disease onset.Interpretation Most patients with SLE and confirmed COVID-19 were able to produce and maintain a serological response despite the use of a variety of immunosuppressants, providing reassurance about the efficacy and durability of humoral immunity and possible protection against re-infection with SARS-CoV-2.

Objective. To evaluate the efficacy of an antLCD5 ricin-linked immunoconjugate (CD5-IC) in patients with rheumatoid arthritis (RA).Methods. A total of 104 evaluable patients were enrolled in a multicenter, double-blind, multiple-dose, placebo-controlled study of CDS-IC.Results. Treatment with CDS-IC in doses up to 8 mg/m2/day for 4 days in 1 month failed to produce marked or prolonged T cell depletion and was no more effective than placebo in ameliorating disease manifestations. An unexpectedly high placebo response was observed in 48% of the patients. Adverse events were correlated with the dose of CDS-IC, but the treatment was generally well-tolerated.Conclusion. At the doses used in this study, CDS-IC was ineffective for treating RA.

No abstract