Rheumatoid Arthritis, SARS-Cov-2 Infection
Conditions
Brief summary
Immune aging or immunosenescence is characterized by a loss of T cell clonal diversity and a contraction of naïve T cells with proliferative capacity associated with the functional impairment of many others immune cells as well as a chronic low degree of inflammation. A restrictive T cell repertoire is likely more prone to antigen-mediated exhaustion observed during chronic viral infections. Notably, lymphopenia is the most consistent laboratory abnormality in COVID-19 infected patients and both lung-resident and circulating T cells potently up-regulate markers of T cell exhaustion. It is not clear today if the association of COVID-19 disease severity with age is mainly related with the immunosenescence of infected patients. Interestingly, T cell exhaustion and premature immunosenescence have also been observed in chronic inflammatory diseases such as rheumatoid arthritis (RA). To better understand the immunological mechanisms involved in SARS-Cov-2 pathophysiology, the investigators propose to compare the immunosenescence patterns observed during RA, aging and SARS-Cov-2 infected patients in order to design improved therapeutic interventions.
Interventions
OTHERBlood sampling
Blood sampling - 10mL
Sponsors
University Hospital, Montpellier
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
for Active RA Patients: * Patients with rheumatoid arthritis (RA) meeting the 2010 ACR/EULAR diagnostic criteria * Patients in inflammatory flare of RA (DAS28 \> 3.2) * Patients who have been off biological disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic antirheumatic drugs (tsDMARDs) for RA for at least 2 weeks (except for rituximab, where a delay of at least 12 months is required) * Conventional synthetic DMARDs (Methotrexate, Hydroxychloroquine, Leflunomide, Sulfasalazine) are allowed * Beneficiary of a social security system * Informed consent Inclusion Criteria for Healthy Controls: * Absence of chronic diseases and current infection * Beneficiary of a social security system * Informed consent Inclusion Criteria for COVID-19+ Patients: * Patients with ongoing SARS-Cov-2 infection (PCR+) * Patients hospitalized at D7-D14 of symptoms onset * Patients with two or more SARS-Cov-2 symptoms (including fever, cough, dyspnea, sore throat, chest pain, anosmia, diarrhea) * Membership in or beneficiary of a social security scheme * Collection of free and informed consent
Exclusion criteria
for All Groups: * Subjects under 18 years of age * HIV positive patients * Diabetic patients * Morbidly obese patients (BMI \> 40kg/m2) * Use of senolytic drugs in the week prior to inclusion (azithromycin, metformin, cyclosporine, JAK inhibitors) * Use of steroids in doses greater than 10 mg/day in the week prior to inclusion * Subjects unable to give consent * Pregnant, breastfeeding, or non-menopausal women not taking effective contraception * Vulnerable subjects protected by law * Subjects under guardianship or curatorship
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Results of phenotypic immunosenescence analyses of COVID-19 patients targeting 5 different immune populations (neutrophils, T lymphocytes, NK lymphocytes, B lymphocytes and monocytes). | At inclusion visit |
Secondary
| Measure | Time frame |
|---|---|
| Comparison of previous results with the results of senescence immunophenotyping in peripheral blood of a reference population of healthy controls. | At inclusion visit |
| Comparison of previous results with the results of senescence immunophenotyping in peripheral blood of a reference population with an inflammatory disease (active RA) | At inclusion visit |
| Identification of a specific gene expression of immunosenescence induced in COVID-19 patients, using transcriptomic analysis in the different immune subpopulations previously identified and specific to COVID-19 patients. | At inclusion visit |
Countries
France
Outcome results
None listed