{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:31:56Z","timestamp":1778509916784,"version":"3.51.4"},"reference-count":45,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T00:00:00Z","timestamp":1703030400000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Biomedical Research Centre at Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust and King\u2019s College London"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,10,4]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Undifferentiated, early inflammatory arthritis (EIA) can differentiate into seropositive or seronegative rheumatoid arthritis (RA), peripheral spondyloarthritis (SpA) or remain as seronegative undifferentiated inflammatory arthritis (UIA). Little is known about immune pathways active in the early stages of SpA and seronegative UIA, in contrast to detailed knowledge of seropositive RA. The aim of this study was to examine if specific immune pathways were active in synovial CD4+ and\u2009CD8+ T cells in EIA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Synovial fluid (SF) samples from 30 patients with EIA were analysed for expression of IL-17A, IFN\u03b3 and TNF\u03b1 in CD8+ or\u2009CD4+ T cells. Final clinical diagnoses were made at least 12 months after sample collection, by two independent clinicians blind to the study data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Flow cytometry analysis of all EIA samples indicated considerable variation in synovial IL-17A+CD8+ T cells (Tc17) cell frequencies between patients. The group with a final diagnosis of SpA (psoriatic arthritis or peripheral SpA, n=14) showed a significant enrichment in the percentage of synovial Tc17 cells compared with the group later diagnosed with seronegative UIA (n=10). The small number of patients later diagnosed with seropositive RA (n=6) patients had few Tc17 cells, similar to our previous findings in established disease. In contrast, RA SF contained a significantly higher percentage of CD8+IFN\u03b3+ T cells compared with SpA or seronegative UIA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These results suggest that adaptive T cell cytokine pathways differ not only between RA and SpA but also seronegative UIA early in the disease process, with a particular activation of Tc17 pathways in early SpA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003328","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T21:40:49Z","timestamp":1703108449000},"page":"e003328","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Type 17-specific immune pathways are active in early spondyloarthritis"],"prefix":"10.1136","volume":"9","author":[{"given":"Catherine D","family":"Hughes","sequence":"first","affiliation":[{"name":"Centre for Inflammation Biology & Cancer Immunology, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Ryan","sequence":"additional","affiliation":[{"name":"Centre for Inflammation Biology & Cancer Immunology, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn J A","family":"Steel","sequence":"additional","affiliation":[{"name":"Centre for Inflammation Biology & Cancer Immunology, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7433-1887","authenticated-orcid":false,"given":"Michelle D","family":"van den Beukel","sequence":"additional","affiliation":[{"name":"Immunology, Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-2290","authenticated-orcid":false,"given":"L A","family":"Trouw","sequence":"additional","affiliation":[{"name":"Immunology, Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin A J","family":"van Schie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9618-6414","authenticated-orcid":false,"given":"Ren\u00e9 E M","family":"Toes","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bina","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Guy's and St Thomas' Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5110-3320","authenticated-orcid":false,"given":"Bruce W","family":"Kirkham","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Guy's and St Thomas' Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9337-7194","authenticated-orcid":false,"given":"Leonie S","family":"Taams","sequence":"additional","affiliation":[{"name":"Centre for Inflammation Biology & Cancer Immunology, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,20]]},"reference":[{"key":"2025090313471101000_9.4.e003328.1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/bmb\/ldm011","article-title":"Early rheumatoid arthritis","volume":"81\u201382","author":"Scott","year":"2007","journal-title":"Br Med Bull"},{"key":"2025090313471101000_9.4.e003328.2","unstructured":"Smolen JS . 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