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Ansary ME et al.  
Expansion of CD4+CD28null T Lymphocytes Contributes to Coronary Artery Diseases in Rheumatoid Arthritis Patients

Journal of Clinical and Basic Cardiology 2012; 15 (1-4): 2-6

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Fig. 1: Flow cytometry

Keywords: CADCD28nullCD4+extra-articular manifestationRA

Background: The expanded CD4+ clonotype T cell subset lacking surface CD28 has been suggested to predispose rheumatoid arthritis (RA) patients to develop more aggressive disease including extra-articular manifestations and CAD. Patients and Methods: The number of circulating CD4+CD28null T cells was evaluated in 42 RA and 10 control subjects by 2-color FACSort flow cytometer, patients underwent evaluation of joint involvement, extra-articular manifestations, and CAD association. Results: The frequency of CD4+CD28null cells was significantly higher in patients than in control subjects. RA patients with persistent expansion of circulating CD4+CD28null cells had more marked increase of extraarticular manifestation (P = 0.000) and CAD (P = 0.000). Expansion of circulating CD4+CD28null T cells correlated significantly with elevated ESR, triglycerides, and seronegative RF. Conclusion: Circulating CD4+CD28null T lymphocytes are increased in RA. Patients with persistent CD4+CD28null T cell expansion show more extra-articular manifestation and CAD. These findings suggest that increased CD4+CD28null T cell expansion, ESR, and triglyceride levels together with seronegative RF can serve as markers to help identify patients with rheumatoid arthritis who are at risk of developing CAD. Moreover, the correlation between CD4+CD28null T cell expansion, ESR, and triglyceride levels together with seronegative RF may be of interest for possible innovative predictive and diagnostic strategies in cardiovascular diseases.
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