Myeloid subpopulations correlate with responsiveness to therapy in a prospective, longitudinal study on RA patients

In a prospective longitudinal cohort of 17 rheumatoid arthritis patients, myeloid subpopulations in synovial tissue are linked to therapy responsiveness, including higher cDC proportions in responders.

• Why it matters: Selecting the most effective RA therapy for an individual remains difficult because target-tissue immune states are not well mapped over time.
• What they did: Ultrasound-guided synovial biopsies were collected at baseline and 4–6-week follow-up, then single-cell CITE-seq (10X Chromium) profiled ~38,000 CD45+ cells; failure to respond was defined by CDAI at 12–18 weeks.
• The result: Responders had significantly higher cDC proportions and significantly lower macrophage proportions, while non-responders showed enrichment of ISG15+ and THBS1+ macrophages, with ISG15+ cells near the synovial lining.

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