Programmed cell death 5 can be a novel biomarker for the prediction of RA incidence and remission

An altered T-cell subpopulation, elevated levels of inflammatory cytokines, and auto-antibodies are frequently present in rheumatoid arthritis (RA). Programmed cell death 5 (PDCD5) is an apoptosis-related gene cloned from TF-1 cells whose main biological roles are to induce apoptosis and immunological regulation. According to a recent study published in Rheumatology and Therapy, the incidence and remission of RA can be substantially correlated with higher PDCD5 expression. 

The study conducted by Dr. Xiao and colleagues included 38 healthy controls and 152 newly diagnosed RA patients, of whom 41 were in both active and stable remission states. In contrast to healthy individuals or those with stable remission status, it was shown that RA patients in an active status had considerably elevated levels of PDCD5 expression. PDCD5 had a stronger predictive value for RA remission than anti-cyclic citrullinated peptide (CCP), erythrocyte sedimentation rate (ESR), and disease activity score 28 scores (DAS28), with an area under the ROC Curve of 0.846 (95% CI 0.780-0.912). According to multiple logistic regression analysis, the probability of developing RA rose 2.94 times higher for those in the high-risk group compared to those in the low-risk group (OR = 2.94, 95% CI = 2.35-4.62, P=0.001) when PDCD5 levels increased. Moreover, similar findings were observed in relation to PDCD5 and RA remission. Following correlation analysis, substantial correlations were found between PDCD5 and the identified genes (FOXP3, TNF-α, IL-17A, IFN-γ, and IL-6) as well as several major clinical indicators, including IgG, rheumatoid factor (RF), CRP, ESR, anti-CCP, and DAS28 score. 

Wang et al. conducted a study involving 18 patients with RA, 22 patients with osteoarthritis (OA), and 40 healthy individuals. The study found that patients with RA had significantly higher levels of PDCD5 in both serum and synovial fluid compared to those with OA and healthy controls. Moreover, serum PDCD5 levels were notably higher in the RF negative group than in the positive group, and they showed a negative correlation with CRP and ESR levels. The findings suggest that the increase in PDCD5 protein expression in RA may be attributed to insufficient apoptosis of fibroblast-like synoviocytes and inflammatory cells. 

The study findings indicated a significant correlation between elevated PDCD5 expression and both the incidence and remission of RA. These results suggest that PDCD5 could potentially serve as a new biomarker for estimating the occurrence and remission of RA. However, to validate and gain a deeper understanding of the precise significance of PDCD5 in the context of RA, further research with larger cohorts is necessary. 

References 

  1. Xiao J, Zhou F, Zhao Z, Cao F, Xiao H, Zhang L, et al. PDCD5 as a Potential Biomarker for Improved Prediction of the Incidence and Remission for Patients with Rheumatoid Arthritis. Rheumatol Ther. 2023 Aug 1.  
  2. Wang JF, Guan ZP, Zhang SL, Pei Z, Chen YY, Pan H. Programmed cell death 5 correlates with disease activity and interleukin-17 in serum and synovial fluid of rheumatoid arthritis patients. Chin Med J (Engl). 2013 Jan;126(2):296–9.