Association of peripheral leukocyte telomere length with patients with rheumatoid arthritis with a focus on interstitial lung disease

Joo, Young Bin; Bang, So-Young; Hong, Su Jin; Lee, Youkyung; Shin, Dongjik; Bae, Sang-Cheol; Lee, Hye-Soon

doi:2025.40.4.676

Korean J Intern Med > Volume 40(4); 2025 > Article

ORIGINAL ARTICLE

Rheumatology

Korean J Intern Med. 2025;40(4):676-686. doi: https://doi.org/10.3904/kjim.2024.148

Association of peripheral leukocyte telomere length with patients with rheumatoid arthritis with a focus on interstitial lung disease

Young Bin Joo^1,2, So-Young Bang^1,2, Su Jin Hong³, Youkyung Lee³, Dongjik Shin⁴, Sang-Cheol Bae^2,5, and Hye-Soon Lee^1,2

¹Division of Rheumatology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
²Hanyang University Institute for Rheumatology Research, Seoul, Korea
³Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
⁴MEDIZEN HUMANCARE Inc., Seoul, Korea
⁵Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea

Corresponding Author: Hye-Soon Lee , Tel: +82-31-560-2241, Fax: +82-31-553-7369, Email: lhsberon@hanyang.ac.kr

Received: April 29, 2024; Revised: September 10, 2024; Accepted: October 28, 2024.

Abstract

Background/Aims: This study investigated whether telomere length (TL) in rheumatoid arthritis (RA) patients is shorter than in controls, whether TL in RA patients with interstitial lung disease (RA-ILD) differs from that in those without ILD (RA-nonILD), and whether TL varies according to RA-ILD patterns.
Methods: TL was measured in peripheral leukocytes using quantitative polymerase chain reaction. Results were compared between controls (n = 14), RA (n = 70), RA-ILD (n = 53), and RA-nonILD (n = 53), and between the subgroups with usual interstitial pneumonia (UIP; n = 32) and nonspecific interstitial pneumonia (NSIP; n = 8), with age- and sex-matching in each comparison. The correlation between TL and honeycombing extent was determined.
Results: RA patients had significantly shorter TL (8.3 ± 2.5 kb) than controls (9.5 ± 0.8 kb; p = 0.002). No significant TL difference was found between RA-ILD and RA-nonILD (8.2 ± 2.8 vs 7.7 ± 2.4 kb, p = 0.271). Among RA-ILD, age (p = 0.011), disease activity (p = 0.018), and UIP (p = 0.038) were significantly associated with shortened TL. TL in UIP was shorter than in NSIP (7.4 ± 1.9 vs. 10.0 ± 3.1 kb, p = 0.026). Honeycombing extent in UIP showed a negative correlation with TL but it was nonsignificant (Rho = -0.131, p = 0.387).
Conclusions: This study confirms that RA is associated with shorter TL than in healthy individuals and suggests variations in TL among RA-ILD subtypes, indicating that telomere involvement in pathogenesis may differ by subtype.

Keywords: Telomere ; Rheumatoid arthritis ; Interstitial lung disease ; Usual interstitial pneumonia