Key result
Rheumatoid arthritis was associated with reduced antibody responses to S. pneumoniae compared to ME/CFS controls, with significant IgG recognition of approximately half the number of antigens.
Why the study?
Patients with rheumatoid arthritis have an increased susceptibility to infections including Streptococcus pneumoniae, but the reasons for this increased susceptibility are poorly understood.
Does rheumatoid arthritis and B-cell depletion therapy impair naturally acquired adaptive immunity to Streptococcus pneumoniae?
Observational
Does rheumatoid arthritis and B-cell depletion therapy impair naturally acquired adaptive immunity to Streptococcus pneumoniae?
Rheumatoid arthritis and B-cell depletion therapy disrupt naturally acquired adaptive immunity to S. pneumoniae, potentially explaining the increased incidence of pneumonia in these patients.
Impaired anti-pneumococcal immunity may heighten infection risk in RA; leaves open B-cell depletion effects and requires prospective validation.
Objectives Patients with rheumatoid arthritis (RA) have an increased susceptibility to infections, including those caused by Streptococcus pneumoniae . Why RA is associated with increased susceptibility to S. pneumoniae is poorly understood. This study aims to assess the effects of RA and B‐cell depletion therapy on naturally acquired antibody responses to 289 S. pneumoniae protein antigens using a novel protein array. Methods IgG responses to S. pneumoniae were characterised in serum from RA patients and disease controls (myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)) using whole‐cell ELISA, a flow cytometry opsonisation assay and an S. pneumoniae protein array. For the RA patients, results were compared before and after B‐cell depletion therapy. Results Compared to a well‐characterised disease control group of ME/CFS patients, RA patients had reduced antibody responses to multiple S. pneumoniae protein antigens, with significant IgG recognition of approximately half the number of antigens along with reduced median strengths of these responses. Reduction in multiple array antigen‐specific responses also correlated with reduced IgG opsonisation of S. pneumoniae . Although B‐cell depletion therapy with rituximab did not reduce overall IgG recognition of S. pneumoniae in the RA group, it was associated with marked disruption of pre‐existing IgG repertoire to protein antigens in individual patients. Conclusion These data show RA is associated with major disruption of naturally acquired adaptive immunity to S. pneumoniae , which can be assessed rapidly using a protein antigen array and is likely to contribute towards the increased incidence of pneumonia in patients with RA.
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Ercoli et al. (2024) conducted an observational in Rheumatoid arthritis. Rheumatoid arthritis vs. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) controls was evaluated on IgG responses to S. pneumoniae protein antigens. Rheumatoid arthritis was associated with reduced antibody responses to S. pneumoniae compared to ME/CFS controls, with significant IgG recognition of approximately half the number of antigens.
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