Immunosenescence in rheumatoid arthritis: Use of CD28 negative T cells to predict treatment response

Not many years ago achieving remission in rheumatoid arthritis (RA) was difficult due to lack of effective treatment. With the advent of biologics, remission is very much within reach. But biologics are expensive. And not all patients respond adequately to biologics. Hence it will be useful if we have a marker which predicts response to any disease modifying anti-rheumatic drug (DMARD), whether conventional or biologic. Expansion of CD28-ve T cells is characteristically seen in RA. Both CD28-ve T Cells and RA are believed to be linked to immunosenescence. The available evidence is suggestive of an intimate relationship between RA and clonal expansion of CD28-ve T cells. Newer biomarkers are constantly being looked at and CD28-ve T cells is one of them. In this review the relationship between immune disorders like RA and immunosenescence and significance of CD28-ve T cells in RA is discussed.