Peripheral Tfr Cells Elevated in Untreated Rheumatoid Arthritis, Small Study Finds

Researchers compared peripheral blood lymphocyte, CD4⁺ T-cell, regulatory T-cell, T follicular helper-cell and Tfr subsets in newly diagnosed, untreated RA patients, treated RA patients and healthy controls. The study included 27 untreated patients, 10 treated patients and 14 controls. Subsets were assessed by flow cytometry, and serum Fgl2 was measured by ELISA. The investigators also analyzed paired pre- and post-treatment samples from patients with RA.

Tfr frequency was higher in untreated patients than in treated patients (4.56% vs 3.16%; P=0.001) and healthy controls (4.56% vs 2.81%; P<0.001). In paired samples, frequency declined from 4.99% before treatment to 3.01% afterward (P=0.015). The study found no clear differences between treated patients and controls, and Tfr proportions did not show obvious correlations with clinical parameters. Fgl2 was reported as higher in the RA group than in controls, but the authors concluded it may not be an ideal RA biomarker.

These findings suggest a treatment-associated change in Tfr frequency, but the small study does not establish that treatment caused the decline or that Tfr measurement is clinically useful. The reported lack of correlation with clinical indicators also limits its potential as a disease-monitoring marker.