Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012;7(5):e36668.
doi: 10.1371/journal.pone.0036668. Epub 2012 May 4.

The features of the synovium in early rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria

Marleen G H van de Sande  1 , Maria J H de Hair, Yvonne Schuller, Gijs P M van de Sande, Carla A Wijbrandts, Huib J Dinant, Danielle M Gerlag, Paul P Tak
Affiliations

The features of the synovium in early rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria

Marleen G H van de Sande et al. PLoS One. 2012.

Abstract

Objectives: It has been shown in early arthritis cohorts that the 2010 ACR/EULAR criteria for rheumatoid arthritis (RA) enable an earlier diagnosis, perhaps at the cost of a somewhat more heterogeneous patient population. We describe the features of synovial inflammation in RA patients classified according to these new criteria.

Methods: At baseline, synovial tissue biopsy samples were obtained from disease-modifying antirheumatic drug (DMARD)-naïve early RA patients (clinical signs and symptoms <1 year). Synovial tissue was analyzed for cell infiltration, vascularity, and expression of adhesion molecules. Stained sections were evaluated by digital image analysis. Patients were classified according to the two different sets of classification criteria, autoantibody status, and outcome.

Findings: Synovial tissue of 69 RA patients according to 2010 ACR/EULAR criteria was analyzed: 56 patients who fulfilled the criteria for RA at baseline and 13 who were initially diagnosed as undifferentiated arthritis but fulfilled criteria for RA upon follow up. The synovium at baseline was infiltrated by plasma cells, macrophages, and T cells as well as other cells, and findings were comparable to those when patients were selected based on the 1987 ACR criteria for RA. There was no clear cut difference in the characteristics of the synovium between RA patients initially diagnosed as undifferentiated arthritis and those who already fulfilled classification criteria at baseline.

Conclusion: The features of synovial inflammation are similar when the 2010 ACR/EULAR classification criteria are used compared to the 1987 ACR criteria.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Patient classification.
Patient classification at baseline and after 2 years follow up according to 2010 ACR/EULAR criteria, and according to outcome after 2 years follow up.
Figure 2
Figure 2. Synovial tissue expression of different cellular markers.
Synovial tissue expression of, CD55+ fibroblast-like synoviocytes (FLS), CD3+ T CD68+ macrophages, CD3+ T cells, CD22+ B cells, CD138+ plasma cells. A:RA patient according to the 1987 ACR criteria, B:RA patient according to the 2010 ACR/EULAR criteria.
See this image and copyright information in PMC

References

    1. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): A randomized, controlled trial. Arthritis Rheum. 2008;58:S126–S135. - PubMed
    1. Finckh A, Liang MH, van Herckenrode CM, de Pablo P. Long-term impact of early treatment on radiographic progression in rheumatoid arthritis: A meta-analysis. Arthritis Rheum. 2006;55:864–872. - PubMed
    1. Nell VP, Machold KP, Eberl G, Stamm TA, Uffmann, et al. Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford) 2004;43:906–914. - PubMed
    1. Visser H, le Cessie S, Vos K, Breedveld FC, Hazes JM. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum. 2002;46:357–365. - PubMed
    1. van der Helm-van Mil AH, le Cessie S, van Dongen H, Breedveld FC, Toes RE, et al. A prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: how to guide individual treatment decisions. Arthritis Rheum. 2007;56:433–440. - PubMed

Publication types

MeSH terms