In a new study, researchers from AU and AUH have cultivated and characterised connective tissue cells from fluid in the patient's joint, which is a contributing factor in the development of rheumatoid arthritis. According to the researchers, this represents a step in the right direction, as they can now test medicine directly on these cells and thereby increase the possibility of personalised treatment.

2021.12.07 | Helle Horskjær Hansen

Biopsies from e.g. patients with rheumatoid arthritis have thus far only been carried out for research purposes to test how cells behave and change, says Morten Aagaard Nielsen, who has headed the study.

One per cent of the population lives with rheumatoid arthritis. And for this one per cent, a new research result from Aarhus University and Aarhus University Hospital is particularly interesting. 

Now it is no longer necessary for patients with rheumatoid arthritis to undergo a biopsy so that connective tissue cells can be cultivated. Researchers can now find and cultivate these cells from the patient's joint fluids, which are, involved in developing and maintaining the disease. 

"This makes it easier for us to test the effect of the medicine directly on the cells in the laboratory, and it gives us hope that in the future we can offer patients personalised treatment," says one of the researchers behind the study, MD and PhD Morten Aagaard Nielsen, from the Department of Biomedicine at Aarhus University and the Department of Rheumatology at Aarhus University Hospital.

The results have been published in the scientific journal Scientific Reports.

Not knowing what works

The present situation is one where when a patient is diagnosed with rheumatoid arthritis, they are subjected to a trial and error approach, without it being possible to say with certainty which medication works for the individual.

“We hope that the type of connective tissue cells and the inflammatory transmitters in the diseased joint are able to predict which treatment will be most effective,” says Morten Aagaard Nielsen.

This is the first time that researchers have succeeded in characterising pathogenic connective tissue cells from the joint fluid and comparing them with cells taken from tissue samples. 

"We can see that these cells can "infect" with arthritis from one joint to another and that they’re able to produce more key disease-accelerating signal molecules, even after they’ve been removed from body," he says and continues: 

"The fact that these cultivated cells from the joint fluid can continue to infect with arthritis from one joint to a previously healthy joint tells us something important about how rheumatoid arthritis may develop over time. At the same time, it also emphasises how important it is to develop medicine targeting precisely these cells and not only classic immune cells,” explains the researcher.

Also of interest for patients with cancer

That these pathogenic connective tissue cells can infect with arthritis is in line with previous research. That connective tissue cells can be grown from joint fluid is also already known, but so far this has only been done without determining the characteristics of these cells, which is what the researchers at Aarhus University have done. 

“The mechanisms and method to cultivate connective tissue cells which can both produce and spread disease is interesting in the context of many inflammatory diseases, primarily inflammatory intestinal diseases, skin diseases and other connective tissue diseases. But it’s also interesting for cancer patients where these cells can be important for the immune system’s ability to fight the cancer,” says Morten Aagaard Nielsen.

According to the researcher, further work to follow up on the results of the study should be done to find and develop treatment options for patients with rheumatoid arthritis. The next step is to examine the role of these cells in arthritis and inflammation, and to do this Morten Aagaard Nielsen will determine how these cells migrate in the body. This study will be carried out in close collaboration with patients and the Department of Rheumatology at Aarhus University Hospital.

The research results – more information

• Facts about the type of study: Translational basic research involving both animal experimentation (in vivo) and test tube methods (in vitro).
• The partners who collaborated on the study come from Aarhus University, Aarhus University Hospital, Justus-Liebig-University Giessen and The University of Freiburg.
• External funding: AUFF and the Danish Arthritis Association.
• Direct link to the the scientific article in Scientific Reports.

Contact:

PhD & MD Morten Aagaard Nielsen
Aarhus University, Department of Biomedicine and
Aarhus University Hospital, Department of Rheumatology
Mobile: (+45) 2870 8924
morten.a.nielsen@biomed.au.dk