Multi-omics monitoring of drug response in rheumatoid arthritis in pursuit of molecular remission

Nat Commun. 2018 Jul 16;9(1):2755. doi: 10.1038/s41467-018-05044-4.

Abstract

Sustained clinical remission (CR) without drug treatment has not been achieved in patients with rheumatoid arthritis (RA). This implies a substantial difference between CR and the healthy state, but it has yet to be quantified. We report a longitudinal monitoring of the drug response at multi-omics levels in the peripheral blood of patients with RA. Our data reveal that drug treatments alter the molecular profile closer to that of HCs at the transcriptome, serum proteome, and immunophenotype level. Patient follow-up suggests that the molecular profile after drug treatments is associated with long-term stable CR. In addition, we identify molecular signatures that are resistant to drug treatments. These signatures are associated with RA independently of known disease severity indexes and are largely explained by the imbalance of neutrophils, monocytes, and lymphocytes. This high-dimensional phenotyping provides a quantitative measure of molecular remission and illustrates a multi-omics approach to understanding drug response.

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / genetics
  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / pathology
  • Biomarkers, Pharmacological / blood
  • Blood Proteins / genetics*
  • Blood Proteins / immunology
  • Case-Control Studies
  • Cell Count
  • Gene Expression Regulation
  • Humans
  • Infliximab / therapeutic use
  • Lymphocytes / drug effects
  • Lymphocytes / immunology
  • Lymphocytes / pathology
  • Methotrexate / therapeutic use*
  • Monocytes / drug effects
  • Monocytes / immunology
  • Monocytes / pathology
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Neutrophils / pathology
  • Proteomics / methods
  • Remission Induction
  • Severity of Illness Index
  • Transcriptome*
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Biomarkers, Pharmacological
  • Blood Proteins
  • Infliximab
  • tocilizumab
  • Methotrexate