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Suppressed diversity of survivin splicing in active rheumatoid arthritis

Journal article
Authors Minna Turkkila
Karin Andersson
S. Amu
Mikael Brisslert
Malin Erlandsson
Sofia Silfverswärd Lindblad
Maria Bokarewa
Published in Arthritis Research & Therapy
Volume 17
Issue 175
ISSN 1478-6354
Publication year 2015
Published at Institute of Medicine, Department of Rheumatology and Inflammation Research
Language en
Links dx.doi.org/10.1186/s13075-015-0689-...
Keywords CELL-DEATH, ANTI-CD20 TREATMENT, VARIANT EXPRESSION, APOPTOSIS PROTEIN, CLINICAL-RESPONSE, DOWN-REGULATION, BREAST-CANCER, RITUXIMAB, ANTIBODIES, LOCALIZATION, Rheumatology
Subject categories Rheumatology and Autoimmunity

Abstract

Introduction: Alternative splicing distinguishes normal and pathologic cells. High levels of oncoprotein survivin recognise patients with severe rheumatoid arthritis (RA). Here, we assess clinical relevance of alternative splicing of survivin in leukocytes of peripheral blood (PBMC) and bone marrow (BM) in RA patients. Method: Transcription of survivin wild-type (survivin-WT), survivin-2B and survivin-Delta Ex3 was measured in 67 randomly selected RA patients and in 23 patients before and after B cell depletion with rituximab. Analysis was done in relation to disease activity, anti-rheumatic treatment and serum levels of rheumatoid factor (RF) and survivin. Results: Survivin-WT was the dominant splice variant equally expressed in T and B cells, while survivin-2B and survivin-Delta Ex3 were higher in B cells. High disease activity (DAS28>5.1) was associated with an excess of survivin-WT and low ratios between survivin-2B/WT (p=0.035) and survivin-Delta Ex3/WT in PBMC. Depletion of B cells by rituximab caused a decrease in survivin-WT (p=0.005) in PBMC, increasing the ratio between survivin-2B/WT (p=0.009) and survivin-Delta Ex3/WT (p=0.001) in BM. This increase in survivin-2B/WT was associated with reduction in CD19+BM cells (r=0.929, p=0.007), RF (IgM, r=0.857, p=0.024; IgA, r=0.739, p=0.021), and DAS28 (0.636, p=0.054). The increase in survivin-Delta Ex3 in BM was associated with a reduction of CD19+BM cells (r=0.714, p=0.058) and DAS28 (r=0.648, p=0.049), while survivin-Delta Ex3/WT was associated with RF (IgG, r=0.882, p=0.016). Conclusion: This study demonstrates that the suppressed diversity of survivin splicing in leukocytes may attribute to adverse self-recognition in RA. Depletion of autoantibody producing B cells improves the balance of survivin splicing.

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