Objective·To investigate the expression of miR-146a in peripheral blood CD4+T lymphocytes of patients with rheumatoid arthritis(RA)and its correlation with inflammatory cytokines such as tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6).Methods·A total of 30 active RA patients who received medical treatment and 30 healthy controls who underwent physical examinations at the People's Hospital of Longhua,Shenzhen from August 2019 to July 2021 were selected.Peripheral blood mononuclear cells(PBMCs)and CD4+T lymphocytes were isolated from venous blood extracted from RA patients and healthy controls,respectively.Quantitative real-time PCR(qPCR)was used to detect the expression of miR-146a in peripheral blood CD4+T lymphocytes,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of TNF-α and IL-6.After transfection of the peripheral blood CD4+T lymphocytes of RA patients with miR-146a mimic,the expression of miR-146a,TNF-α and IL-6 was detected again.The correlations between miR-146a expression and TNF-α and IL-6 expression in RA patients,both before and after transfection,were analyzed by using Pearson correlation coefficient.Results·Before transfection with miR-146a mimic,the expression levels of miR-146a,TNF-α and IL-6 in peripheral blood CD4+T lymphocytes of RA patients were significantly higher than those of healthy controls(all P＜0.001).After transfection,the expression of miR-146a in peripheral blood CD4+T lymphocytes of RA patients was significantly higher,and the expression of TNF-α and IL-6 was significantly lower(all P＜0.001).The results of Pearson correlation analysis showed that the expression of miR-146a in peripheral blood CD4+T lymphocytes of RA patients,both before and after transfection,was positively correlated with the expression of TNF-α and IL-6,respectively(r=0.959,P＜0.001;r=0.916,P＜0.001;r=0.971,P＜0.001;r=0.861,P＜0.001).Conclusion·miR-146a can regulate the levels of TNF-α and IL-6 in peripheral blood CD4+T lymphocytes of RA patients,indicating that miR-146a may play a role in the pathogenesis of RA.

OBJECTIVE: To comprehensively understand the COVID-19 vaccination and infection status among patients with systemic sclerosis (SSc). METHODS: We conducted a retrospective analysis of patients diagnosed with SSc who were hospitalized in the Rheumatology and Immunology Department of Peking University People' s Hospital from January 2016 to March 2023. We collected detailed clinical cha-racteristics, vaccination status, and infection details through a systematic review of medical records and telephone follow-ups with the SSc patients. RESULTS: Out of 236 identified patients, 99 SSc patients participated in the follow-up. This cohort included 41 patients with limited SSc, 28 with diffuse SSc, and 30 with SSc overlap syndromes. Treatments varied, with glucocorticoids administered to 57.58% of patients, immunosuppressants to 56.57%, biologic agents to 7.07%, and small molecule targeted therapies to 6.06%. Notably, 49 patients had received the COVID-19 vaccine. Between November 2022 and March 2023, a total of 81 patients contracted COVID-19. The infection rate among those who received three doses or more (19/29, 65.5%) was significantly lower compared with unvaccinated patients (45/50, 90.0%, P=0.007). Fourteen of these patients required hospitalization due to COVID-19. Furthermore, 26 patients reported exacerbation of SSc symptoms post-infection, which included severe manifestations, such as Raynaud phenomenon, skin lesions, fingertip ulcers, pulmonary hypertension, and interstitial lung disease. Compared with healthy cohabitants, the SSc patients exhibited more severe symptoms following COVID-19, including fever (36.71%) and fatigue (35.44%). Multivariate regression analysis identified subcutaneous calcinosis (OR=7.713, 95%CI: 1.142-45.051) and positivity for anti-centromere antibodies (OR=9.210, 95%CI: 1.211-70.028) as independent risk factors for hospitalization due to COVID-19. CONCLUSION Vaccination is both effective and safe in preventing COVID-19 among SSc patients. Additionally, it underscores that these patients experience exacerbation of their underlying disease and more severe COVID-19 symptoms compared with individuals without underlying conditions. Thus, proactive prevention, continuous monitoring, and early treatment of COVID-19 are of significant importance for the health and well-being of SSc patients. Timely interventions can help mitigate the impact of infections and improve overall patient outcomes.
Humans ; COVID-19/epidemiology* ; Scleroderma, Systemic/complications* ; COVID-19 Vaccines/administration & dosage* ; Retrospective Studies ; Male ; Female ; Middle Aged ; SARS-CoV-2 ; Vaccination ; Immunosuppressive Agents/therapeutic use* ; Cohort Studies