A new study published in Experimental & Molecular Medicine, led by researchers from the Catholic University of Korea, Seoul National University, and Soonchunhyang University College of Medicine, has suggested the use of analysis of lipidome profiles for the identification of biomarker candidates that may assist in predicting the evolution of preclinical to definitive RA. They may also help in assessing the disease activity and treatment outcomes.
The researchers carried out untargeted lipidomics analysis of serum and synovial fluid of RA patients at different disease activities, and preclinical, active and sustained remission phases. Severe abnormal lipidome profiles were noted for the RA joint fluid, which correlated with the degree of inflammation and synovitis severity on ultrasonography. The active RA lipidome profile manifested significant distinctive expression, which was different from sustained remission phase of RA and noninflammatory osteoarthritis.
The researchers noted a correlation between RA activity and alterations in lysophosphatidylcholine, phosphatidylcholine, ether-linked phosphatidylethanolamine, and sphingomyelin subclasses. The serial monitoring of these alterations has also revealed response towards anti-rheumatic drugs. One of the distinctive findings was that the lipidome changes were already established before the disease progression at the preclinical phase. The lipid profile of patients with highly active RA and increased ESR/CRP was similar to preclinical RA patients with normal ESR/CRP, indicating that the abnormal lipid metabolism may precede the clinical and laboratory manifestations of RA.
The present study is the first of its kind providing evidence on the usefulness of lipidome signatures in identification of biomarker candidates that can predict disease evolution and activity. There is an unsatisfiable need of RA activity and treatment outcome assessment. Lipid profile can be a better predictor of disease progression than ESR, CRP and DAS28 and provides new approach towards treating RA. However, further validation of current study biomarkers in further large -scale clinical studies is required.
Reference: Koh, J.H., Yoon, S.J., Kim, M. et al. Lipidome profile predictive of disease evolution and activity in rheumatoid arthritis. Exp Mol Med (2022).