Unusual new cell discovery predicts rheumatoid arthritis flare-up

For a while now, researchers have been searching for some sort of indication or method by which rheumatoid arthritis flare-ups could be predicted. This is known as a “biomarker,” or a measurable indicator that can be used to predict a medical phenomenon. A new discovery of never-before-seen cells, dubbed as PRIME cells, could be the biomarker for rheumatoid arthritis flare-up. The study was published in The New England Journal of Medicine.

The researchers noticed that these PRIME cells would appear 7 days before a rheumatoid arthritis flare-up, but then disappear during the flare. This phenomenon was seen in the four rheumatoid arthritis patients that were a part of the novel study, who collected weekly samples of finger-pricked blood for up to four years. Along with these samples, the flare-ups were also documented in order to search for some sort of connection.

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What the researchers found was a strange cell with a unique RNA profile, that has not been seen before, suddenly appear about 7 days before the flare begins. The cell resembled synovial fibroblasts, cells that are usually found at the joints and not in the bloodstream.

Dana Orange, co-author of the study, says “That got us thinking there was something fishy going on. We were so surprised to see that the genes expressed right before a flare are normally active in the bone, muscle, and extracellular matrix–strange pathways to find in blood cells.”

Another very interesting theory might explain how the cause of a rheumatoid arthritis flare-up might be these PRIME cells themselves. Researchers theorize that the PRIME cells might be migrating from the bloodstream and into the joints, causing the pain. Though the phenomenon of disappearing PRIME cells has been observed in a few patients, it requires a larger-scale study on multiple patients to be completely verified.

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If the PRIME cells are identified as the cause for rheumatoid arthritis flare-ups, they could be the key target in novel treatment that aims to stop a flare-up before it happens. Darnell says, “PRIME cells are one thing you might want to target to arrest the flare before it happens. That’s the ideal of medical science – to know enough about a disease that you can put your finger on what’s about to make someone sick. If these cells are the antecedents to joint sickness, they become a potential target for new drugs.”

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Sources: New AtlasHoward Hughes Medical InstituteRockefeller University

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