Using Synovial Tissue Biopsies to Develop Precision Medicine for Rheumatoid Arthritis Save

Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoid arthritis (RA) patients.(Citation source: https://buff.ly/2FPmgKA)

This attempt at precision medicine is driven by the "trial and error" approach to RA therapy, low response or incomplete response to very good drugs and evidence showing no correlations with blood sampling or clinical parameters.

This was a multi-site study of 41 rheumatoid arthritis patients who underwent US-guided synovial biopsies.

Participating sites included Northwestern University; the University of Alabama at Birmingham; Washington University, Columbia University, Mayo Clinic and University of Michigan.

Whole tissue samples from RA patients had a high degree of transcriptional heterogeneity. However,  the transcriptional profile of isolated RA synovial macrophages highlighted a subpopulation of patients and identified six novel transcriptional modules that were associated with disease activity and therapy. 

In the next phase of research, investigators will do pre- and post treatment (6 weeks later) biopsies to identify predictor gene sequence that will clearly identify which patients respond to a particular therapy.