RNA sequencing to predict response to TNF-α inhibitors reveals possible mechanism for nonresponse in smokers

Bart V J Cuppen*, Marzia Rossato, Ruth D E Fritsch-Stork, Arno N Concepcion, Suzanne P Linn-Rasker, Johannes W J Bijlsma, Jacob M van Laar, Floris P J G Lafeber, Timothy R Radstake,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Several studies have employed microarray-based profiling to predict response to tumor necrosis factor-alpha inhibitors (TNFi) in rheumatoid arthritis (RA); yet efforts to validate these targets have failed to show predictive abilities acceptable for clinical practice. Methods: The eighty most extreme responders and nonresponders to TNFi therapy were selected from the observational BiOCURA cohort. RNA sequencing was performed on mRNA from peripheral blood mononuclear cells (PBMCs) collected before initiation of treatment. The expression of pathways as well as individual gene transcripts between responders and nonresponders was investigated. Promising targets were technically replicated and validated in n = 40 new patients using qPCR assays. Results: Before therapy initiation, nonresponders had lower expression of pathways related to interferon and cytokine signaling, while also showing higher levels of two genes, GPR15 and SEMA6B (p = 0.02). The two targets could be validated, however, additional analyses revealed that GPR15 and SEMA6B did not independently predict response, but were rather dose-dependent markers of smoking (p < 0.0001). Conclusions: The study did not identify new transcripts ready to use in clinical practice, yet GPR15 and SEMA6B were recognized as candidate explanatory markers for the reduced treatment success in RA smokers.

Original languageEnglish
Pages (from-to)623-633
Number of pages11
JournalExpert Review of Clinical Immunology
Volume14
Issue number7
Early online date6 Jun 2018
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Journal Article
  • RNA sequencing
  • TNF-alpha
  • response
  • prediction
  • mRNA
  • qPCR
  • rheumatoid arthritis
  • Prognosis
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Biomarkers, Pharmacological
  • Male
  • Gene Expression Profiling
  • Tumor Necrosis Factor-alpha/antagonists & inhibitors
  • Antirheumatic Agents/pharmacology
  • Cigarette Smoking
  • Receptors, Peptide/genetics
  • Adult
  • Female
  • Drug Resistance
  • Leukocytes, Mononuclear/physiology
  • Semaphorins/genetics
  • Receptors, G-Protein-Coupled/genetics
  • Sequence Analysis, RNA
  • Aged
  • Arthritis, Rheumatoid/diagnosis
  • Cohort Studies

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