A vile of blood with 7 dots along the side. Above each dot is a drop of blood. On the 6th drop it is a flame instead.

New Blood Test May Predict Rheumatoid Arthritis Flares

New research has found a type of cell that appears in the blood of people with rheumatoid arthritis shortly before they experience flares.1,2 Scientists from the Howard Hughes Medical Institute published the findings in the New England Journal of Medicine.

Discovering new flare predictor cells

The newly identified cells, called “PRIME cells”, show up in the blood the week before an RA flare, according to the research.1,2 Realizing that traveling to labs for frequent blood tests is a challenge for patients, the researchers developed an at-home blood collection where patients gave themselves finger sticks and then sent the blood to the research lab. The study participants also recorded their symptoms to track when flares occurred.

An increase in immune cells prior to a flare

The researchers compared the blood results to find changes right before the start of a flare and identify types of cells in the blood before flares. They found an increase in immune cells in the blood two weeks before a flare. The same cells are known to attack joints in RA patients.

PRIME (pre-inflammation mesenchymal) cells

Blood samples one week before a flare have a new type of cell not previously identified. They call it a PRIME cell for “pre-inflammation mesenchymal” as mesenchymal refers to cells from bone or cartilage. These newly identified cells gathered in the blood one week prior to a flare, but then disappeared during the flare.

While there is still more to learn, previous research in mice suggests a correlation between these cells and RA flares. The team plans to test more patients to investigate whether finding these cells can predict a future flare. Another area for future research is studying the characteristics of these cells to better understand how they operate.

The goal of this line of research is to understand how flares happen on a cellular level and eventually target treatments on these cells to treat or prevent RA flares.

How can predictor cells help?

As a patient, I have experienced too many times the debilitating effects of flares, whether it’s the pain, stiffness, fatigue, or nasty combination of multiple symptoms. The possibility of trying to anticipate flares is exciting to me as I am often surprised (and feel unprepared) for their onset.

One of the big struggles of responding to flares is their swift and sudden appearance. If I knew one was coming, it may be possible to ready my response such as starting some extra prednisone.

Future research may help us with RA flares

Even further, if research could identify the molecular triggers of flares and then create treatments to stop or lessen them, then that could be life-changing for RA patients.

I think many of us know the daily struggles of RA can be hugely significant, but flares attack on a whole other level. I may be coping in my day-to-day, but when hit with a flare I can be knocked flat. A flare may mean bed rest, sick days, canceled plans, and many more consequences — along with feeling terrible and trying to get through.

Research like this can be very impactful on RA patients. While it may now just hint at possibilities, it’s encouraging to have these potential ideas to help RA patients live with this painful condition.

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