Phenotyping of multiple biofluids for liquid biomarkers for diagnostics and personalized medicine of rheumatoid arthritis, spondyloarthritis and osteoarthritis

Background: Inflammatory and autoimmune diseases include multifactual pathomechanisms and systemic responses. The etiology of the joint diseases rheumatoid arthritis (RA), spondyloarthritis (SpA) in relation to osteoarthritis (OA) remain incomplete and establishing the correct diagnose remains nontrivial. Advances in high-throughput molecular technologies have increased investigations into the utility of transcriptomic, proteomic and high-density protein arrays approaches as diagnostic tools and companion diagnostics for precision medicine. To increase our understanding of the molecular pathogenesis, we extracted synovial fluid from the joints from multiple patient groups and characterized the protein composition in relation to plasma. Basic blood tests include inflammatory markers and autoantibodies, however, now analysis speed and robustness allow more readily clinical insight biofluids.Objectives: We present recent Omics concepts and studies investigating inflammatory state and treatment outcome in different biofluids from plasma to synovial fluid accessing causalities leading to inflammation and pain. Additionally, the aim was to investigate in any proteomic findings in synovial fluid can be correlated to proteomic changes in patient plasma and can be used as biomarkers for treatment effect.Methods: Plasma and synovial fluid were investigated in multiple pathologies before and after treatment in patients (biologics; MTX; intraarticular gold). Deep proteome, PTM and EV profiling were accomplished using quantitative proteomics approaches using quantitative mass spectrometry-based analysis by DIA/PASEF followed by deep datamining. All biological samples were digested according to a Filter Aided Sample Preparation (FASP) protocol before analysis with tandem mass spectrometry (MS/MS). PTM profiling were evaluated by 4D CCS based feature finding.Results: Mass spectrometry based profiling allowed quantitative profiling of up to 480 proteins in matched synovial fluid and plasma. Complementary analysis by Olink proteomics, cytokine profiling and cell-free DNA. Multiple acute inflammatory proteins were more abundant in the RA synovial fluid, including proteins originating from neutrophil granulocytes, whereas SpA patients had a higher concentration of haptoglobin. Complementary analysis by Olink immunoassay identified significantly downregulated inflammation markers out of 96 tested in relation to antiinflammatory treatment.Conclusion: Discovery of biomarkers and/or inflammatory signatures through integration of multi-omic data allowed stratify patients for improved treatment and prognosis. Firstly, our data using next generation proteomics approaches alleviates many pitfalls of missing values and poor proteome coverage including unbiased PTM profiling without enrichment strategies.Disclosure of Interests: None declared