THE POTENTIAL of high-content imaging as a game-changer for precision medicine in rheumatoid arthritis (RA) has been highlighted in a new study. The research, which applies advanced microscopy to study immune cells, offers a novel approach for characterizing disease activity and predicting treatment responses in patients with RA.
Current RA treatment relies largely on trial and error, with no reliable biomarkers to predict how a patient will respond to specific therapies. This study sought to address that gap by developing a high-throughput microscopy-based screening tool. The tool analyzes peripheral blood mononuclear cells (PBMCs) from patients with RA to quantify cell types, morphology, and interactions after exposure to various RA-specific drugs.
Researchers tested PBMCs from 65 patients with RA and 33 healthy controls. The samples were exposed to RA-specific small molecules, biologics, and reference stimuli for 24 hours. By examining the ex vivo response, the team identified unique immune cell phenotypes associated with disease activity and different treatment regimens.
Notably, the screening revealed that biologic DMARD (disease-modifying anti-rheumatic drug) treatment caused significant morphological changes in immune cells. Patients on conventional synthetic DMARDs also showed distinct immune cell patterns compared to healthy controls. By integrating clinical data with imaging results, the researchers were able to cluster patients based on disease activity and treatment response.
This proof-of-concept study demonstrates the feasibility of using high-content imaging to personalize RA treatment. It aligns with the broader trend of functional precision medicine, which has been successful in oncology. By evaluating drug effects on a cellular level, this approach may offer rheumatologists a new tool to tailor treatments and improve patient outcomes.
The next steps will involve refining the technology for clinical use and expanding it to other autoimmune diseases. If successful, this imaging-based approach could help shift RA treatment from trial-and-error to precision-guided care, ultimately enhancing patient outcomes and quality of life.
Reference: Kartnig F et al. Ex vivo imaging-based high content phenotyping of patients with rheumatoid arthritis. eBioMedicine. 2025;111:105522.
Anaya Malik | AMJ
