The efficacy of TNF antagonists and B cell depletion therapy (BCDT) in rheumatoid arthritis (RA) have fundamentally altered pathophysiologic paradigms and raised new questions about disease mechanisms. The observation that both TNF and B cells are of central importance provides a strong impetus to improve our understanding ofthe relationship between TNF over-production and inflammation pathways mediated by B cells, particularly in regards to disease flares and inadequate treatment response. The TNF-transgenic (TNF-tg) mouse strain is the only chronically progressive model for RA with a clinically proven etiology, and thus invaluable to address the cellular and immunological events in RA. We have developed a series of novel small animal imaging approaches, including contrast enhanced (CE) MRI, in vivo micro-CT and near infrared indocyanin green (NIR-ICG) analysis of lymphatic flow, to study longitudinally the events associated with progression of joint arthritis. The results from these studies, combined with histology and flow cytometry, showed dramatic changes unfolding in a predictable temporal sequence in the draining popliteal lymph-node (PLN) before and during the onset of knee disease. Prior to knee synovitis, the draining PLNs

Public Health Relevance

Rheumatoid arthritis (RA) is a debilitating joint disease, which is manifested by episodic flares, and affects >1% of our populations. Here we propose to elucidate the role of B cells in arthritic flares, and evaluate a novel clinical outcome measures in RA patients undergoing B cell depletion therapy (rituximab) to better understand the differences between responders and non-responders.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program Projects (P01)
Project #
5P01AI078907-04
Application #
8528455
Study Section
Special Emphasis Panel (ZAI1-PA-I)
Project Start
2013-08-01
Project End
2015-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
4
Fiscal Year
2013
Total Cost
$354,011
Indirect Cost
$28,397
Name
Emory University
Department
Type
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Meednu, Nida; Zhang, Hengwei; Owen, Teresa et al. (2016) Production of RANKL by Memory B Cells: A Link Between B Cells and Bone Erosion in Rheumatoid Arthritis. Arthritis Rheumatol 68:805-16
Rahimi, Homaira; Bell, Richard; Bouta, Echoe M et al. (2016) Lymphatic imaging to assess rheumatoid flare: mechanistic insights and biomarker potential. Arthritis Res Ther 18:194
Kuzin, Igor I; Kates, Stephen L; Ju, Yawen et al. (2016) Increased numbers of CD23(+) CD21(hi) Bin-like B cells in human reactive and rheumatoid arthritis lymph nodes. Eur J Immunol 46:1752-7
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Adlowitz, Diana G; Barnard, Jennifer; Biear, Jamie N et al. (2015) Expansion of Activated Peripheral Blood Memory B Cells in Rheumatoid Arthritis, Impact of B Cell Depletion Therapy, and Biomarkers of Response. PLoS One 10:e0128269
Bird, Anna K; Meednu, Nida; Anolik, Jennifer H (2015) New insights into B cell biology in systemic lupus erythematosus and Sjögren's syndrome. Curr Opin Rheumatol 27:461-7
Wilmore, Joel R; Asito, Amolo S; Wei, Chungwen et al. (2015) AID expression in peripheral blood of children living in a malaria holoendemic region is associated with changes in B cell subsets and Epstein-Barr virus. Int J Cancer 136:1371-80
Halliley, Jessica L; Tipton, Christopher M; Liesveld, Jane et al. (2015) Long-Lived Plasma Cells Are Contained within the CD19(-)CD38(hi)CD138(+) Subset in Human Bone Marrow. Immunity 43:132-45
Bouta, Echoe M; Li, Jie; Ju, Yawen et al. (2015) The role of the lymphatic system in inflammatory-erosive arthritis. Semin Cell Dev Biol 38:90-7
Wei, Chungwen; Jenks, Scott; Sanz, Iñaki (2015) Polychromatic flow cytometry in evaluating rheumatic disease patients. Arthritis Res Ther 17:46

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