Abstract

ObjectivesNeutrophils are typically the most abundant leukocyte in arthritic synovial fluid. We sought to understand changes that occur in neutrophils as they migrate from blood to joint. MethodsWe performed RNA sequencing of neutrophils from healthy human blood, arthritic blood, and arthritic synovial fluid, comparing transcriptional signatures with those from murine K/BxN serum transfer arthritis. We employed mass cytometry to quantify protein expression and sought to reproduce the synovial fluid phenotype ex vivo in cultured healthy blood neutrophils. ResultsBlood neutrophils from healthy donors and patients with active arthritis exhibited largely similar transcriptional signatures. By contrast, synovial fluid neutrophils exhibited more than 1,600 differentially expressed genes. Gene signatures identified a prominent response to interferon gamma (IFN{gamma}), as well as to tumor necrosis factor, interleukin 6, and hypoxia, in both humans and mice. Mass cytometry also found healthy and arthritic donor blood neutrophils largely indistinguishable but revealed a range of neutrophil phenotypes in synovial fluid defined by downregulation of CXCR1 and upregulation of Fc{gamma}RI, HLA-DR, PD-L1, ICAM-1 and CXCR4. Reproduction of key elements of this signature in cultured blood neutrophils required both IFN{gamma} and prolonged culture. ConclusionsCirculating neutrophils from arthritis patients resemble those from healthy controls, but joint fluid cells exhibit a network of changes, conserved across species, that implicate IFN{gamma} response and aging as complementary drivers of the synovial neutrophil phenotype. KEY MESSAGESO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LINeutrophils are central in the effector phase of inflammatory arthritis but their phenotypic heterogeneity in inflamed synovial fluid is poorly understood. C_LI What does this study add?O_LIRNA-seq and mass cytometry identify a hallmark phenotype of neutrophils in synovial fluid consisting of upregulated ICAM-1, HLA-DR, PD-L1, Fc receptors and CXCR4. C_LIO_LITranscriptomics highlight an IFN{gamma} response signature conserved across humans and mice. C_LIO_LIIn vitro experiments implicate aging and IFN{gamma} as complementary factors orchestrating the synovial fluid neutrophil phenotype. C_LI How might this impact on clinical practice or future developments?O_LIUnderstanding the specific features of neutrophils in the arthritic joint may disclose opportunities for safe therapeutic targeting of this lineage. C_LI