<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="2.3" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2022.1044909</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Immunology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Identification of biomarkers associated with CD8+ T cells in rheumatoid arthritis and their pan-cancer analysis</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Zhao</surname>
<given-names>Zhenyu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1926582"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ren</surname>
<given-names>Jie</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Xie</surname>
<given-names>Siping</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zou</surname>
<given-names>Longchun</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhao</surname>
<given-names>Qianyue</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zeng</surname>
<given-names>Shan</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zha</surname>
<given-names>Dingsheng</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>    <uri xlink:href="https://loop.frontiersin.org/people/1581560"/>
</contrib>
</contrib-group>    <aff id="aff1">
<sup>1</sup>
<institution>Department of Orthopedics, The First Affiliated Hospital, Jinan University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Rheumatology, The First Affiliated Hospital, Jinan University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Medical Records, The First Affiliated Hospital, Jinan University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>School of Stomatology, Jinan University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>School of Basic Medicine and Public Health, Jinan University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Hai-Feng Pan, Anhui Medical University, China</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Hao Zhiquan, Henan Provincial People&#x2019;s Hospital, China; Denghui Xie, Southern Medical university, China</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Dingsheng Zha, <email xlink:href="mailto:zdsuser@126.com">zdsuser@126.com</email>; Shan Zeng, <email xlink:href="mailto:zs870103@126.com">zs870103@126.com</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
<fn fn-type="other" id="fn002">
<p>This article was submitted to Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders, a section of the journal Frontiers in Immunology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>11</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>13</volume>
<elocation-id>1044909</elocation-id>
<history>
<date date-type="received">
<day>15</day>
<month>09</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>04</day>
<month>11</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Zhao, Ren, Xie, Zou, Zhao, Zeng and Zha</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Zhao, Ren, Xie, Zou, Zhao, Zeng and Zha</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>Rheumatoid arthritis (RA), a prevailing chronic progressive autoimmune disease, seriously affects the patient's quality of life. However, there is still a lack of precise treatment and management methods in clinical practice. Previous studies showed that CD8+ T cells take a lead in the progression of RA.</p>
</sec>
<sec>
<title>Methods</title>
<p>Genes closely related to CD8+T cells in RA were identified through multiple RA datasets, CIBERSORT, and WGCNA algorithms. Further machine learning analysis were performed to identify CD8+T cell-related genes most closely related to RA. In addition, the relationship between these three key genes and 33 cancer species was also explored in this study.</p>
</sec>
<sec>
<title>Results</title>
<p>In this study, 10 genes were identified to be closely related to CD8+T cells in RA. Machine learning analysis identified 3 CD8+T cell-related genes most closely related to RA: CD8A, GZMA, and PRF1.</p>
</sec>
<sec>
<title>Discussion</title>
<p>Our research aims to provide new ideas for the clinical treatment of RA.</p>
</sec>
</abstract>
<kwd-group>
<kwd>CD8+ T Cells<sub>1</sub>
</kwd>
<kwd>rheumatoid arthritis<sub>2</sub>
</kwd>
<kwd>WGCNA<sub>3</sub>
</kwd>
<kwd>Pan-Cancer<sub>4</sub>
</kwd>
<kwd>ssGSEA<sub>5</sub>
</kwd>
</kwd-group>
<counts>
<fig-count count="10"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="38"/>
<page-count count="13"/>
<word-count count="3568"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>Rheumatoid arthritis (RA) is a common chronic autoimmune disease associated with systemic inflammatory processes. This chronic damage first affects the patient&#x2019;s bones and joints (<xref ref-type="bibr" rid="B1">1</xref>). The progression of the disease will affect the patient&#x2019;s quality of life, bringing a huge economic burden to individuals and society. Another prominent manifestation of RA is systemic inflammatory lesions outside the joints, in particular, the digestive system, nervous system, cardiovascular system, etc (<xref ref-type="bibr" rid="B2">2</xref>). Furthermore, because of the significant variability of RA disease, it is challenging to distinguish it clinically from other autoimmune disorders (such as systemic lupus erythematosus, Sj&#xf6;gren&#x2019;s syndrome, etc.) (<xref ref-type="bibr" rid="B3">3</xref>) and face challenges in the administration of chemotherapy (<xref ref-type="bibr" rid="B4">4</xref>). In the developed world, RA affects between 0.5 and 1% of adults, or about 24.5 million people, with 5 to 50 new cases per 100,000 people every year (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>). The aforementioned issues require immediate attention given the significant prevalence of RA in the general population.</p>
<p>CD8+ T cells, also known as cytotoxic T cells, play an important role in the elimination of malignant cells and intracellular inflammation in the body (<xref ref-type="bibr" rid="B7">7</xref>). Current research shows that in the face of infection, inflammation, tumor, and other pathological conditions, the metabolic level of CD8+ T cells and the anti-inflammatory phenotype exhibited by the body will undergo various changes (<xref ref-type="bibr" rid="B8">8</xref>). Some studies show that its epigenetic modifications also alter (<xref ref-type="bibr" rid="B9">9</xref>). The current consensus is that CD8+ T cells promote the progression of RA by releasing pro-inflammatory and cytolytic mediators (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B11">11</xref>). The study by M Margarida Souto-Carneiro et&#xa0;al. (<xref ref-type="bibr" rid="B12">12</xref>) mentions that metabolic demands in hypoxic tissues sustain the continued damage of this cell to the joint. A study by Helena Carvalheiro et&#xa0;al. (<xref ref-type="bibr" rid="B10">10</xref>) revealed the full landscape of CD8+ T cells in RA, revealing that CD8+ T cells are characterized by upregulation and secretion of inflammatory mediators throughout RA. The above studies all illustrate the important role of CD8+ T cells in the progression of RA and may become an excellent intervention target for clinical RA treatment.</p>
<p>In this study, based on the results of the CIBERSORT algorithm and weighted gene correlation networks analysis (WGCNA) analysis, we finally identified 10 key CD8+ T cell-related genes. The three genes most closely related to CD8+ T cell infiltration in RA, namely CD8A, GZMA, and PRF1, were found to be associated with a variety of cancers. This points out a new path for the treatment of RA.</p>
</sec>
<sec id="s3" sec-type="materials|methods">
<title>Material and methods</title>
<sec id="s3_1">
<title>Collection and processing of gene expression data</title>    <p>The GSE55235 (<xref ref-type="bibr" rid="B13">13</xref>), GSE1919 (<xref ref-type="bibr" rid="B14">14</xref>), GSE48780 (<xref ref-type="bibr" rid="B15">15</xref>), GSE55457 (<xref ref-type="bibr" rid="B13">13</xref>), and GSE55584 (<xref ref-type="bibr" rid="B13">13</xref>) datasets were retrieved and downloaded from the Gene Expression Omnibus(GEO, <uri xlink:href="https://www.ncbi.nlm.nih.gov/geo/">https://www.ncbi.nlm.nih.gov/geo/</uri>). Limma package was used to normalize the data and convert between probe ID and gene symbol through platform information, removing probes without gene symbol and taking the average expression value of multiple probes under the same symbol (<xref ref-type="bibr" rid="B16">16</xref>). We used variation coefficients to select the most significantly varied genes for analysis.</p>
</sec>
<sec id="s3_2">
<title>Analysis of immune cell infiltration</title>
<p>The proportion of 22 immune cell types and the infiltration of immune cells in samples from GSE55235, GSE1919, GSE48780, GSE55457, and GSE55584 datasets was calculated using the CIBERSORT algorithm (<xref ref-type="bibr" rid="B17">17</xref>).</p>
</sec>
<sec id="s3_3">
<title>Construction of WGCNA co-expression network</title>
<p>&#x201c;WGCNA&#x201d; was used to construct a gene co-expression network for genes in the GSE55235 dataset with a variation coefficient greater than 0.1. The top 25% of highly expressed variants were analyzed (<xref ref-type="bibr" rid="B18">18</xref>). The reliability of the constructed scale-free network is ensured by removing abnormal samples. For that, they were used to approximate appropriate soft threshold rates and obtain adjacency values between genes whose variances were more significant before applying power functions. The adjacency values were then converted into topological overlap matrices (TOM) and derived the dissimilarity (1-TOM) values. The dynamic tree-cutting method was finally used to identify modules by hierarchical clustering of genes.</p>
</sec>
<sec id="s3_4">
<title>Building blocks feature relation</title>
<p>Each module underwent component analysis according to its features, and the correlation between module characteristics and T-cell subtypes was then analyzed using the Pearson test. We considered the module significantly correlated with T cell subtypes when P&lt;0.05. The central module was defined as that with the highest correlation coefficient with CD8+T cells.</p>
</sec>
<sec id="s3_5">
<title>Hub gene selection and validation</title>
<p>Based on the module connectivity and clinical characteristic relationships of each gene in the central module, candidate central genes were chosen. Pearson&#x2019;s correlation between genes&#x2019; absolute values is used to describe module connectivity. The overall Pearson&#x2019;s correlation between each gene and each characteristic was used to identify the relationship between clinical traits. For candidate central genes, we set gene significance &gt;0.75. Verify whether there is a significant correlation between the candidate hub genes and CD8+T, to determine the reliable hub genes. GSE1919, GSE48780, GSE55457, and GSE55584 datasets were used to verify the Spearman correlation between CD8+T cell and central gene expression. Hub genes were defined as candidate hub genes that were significantly associated with CD8+T cells in the GSE55235, GSE1919, GSE48780, GSE55457, and GSE55584. In addition, CIBERSORT, MCPCOUNTER, QUANTISEQ, TIMER, and XCELL algorithms were used to verify the correlation between genes and CD8+T cells in different tumors.</p>
</sec>
<sec id="s3_6">
<title>Identification of key genes using LASSO regression and random forest</title>
<p>Critical genes for T cell CD8+ were identified using the LASSO regression and random forest algorithms. Least Absolute Shrinkage and Selection Operator (LASSO) regression is performed using the &#x201c;glmnet&#x201d; package. RF is implemented using the &#x201c;randomForest&#x201d; package (<xref ref-type="bibr" rid="B19">19</xref>). A Venn diagram was used to visualize the results of the two algorithms and obtain the intersection genes.</p>
</sec>
<sec id="s3_7">
<title>Functional and pathway enrichment analysis</title>
<p>We examined genes using Gene Ontology (GO) analysis (<xref ref-type="bibr" rid="B20">20</xref>), which comprised molecular function (MF), cellular component (CC), and biological process (BP), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis (<xref ref-type="bibr" rid="B21">21</xref>).</p>
</sec>
<sec id="s3_8">
<title>Hub gene correlation</title>    <p>Genes GSE55235, GSE1919, GSE48780, GSE55457, and GSE55584 were correlated, and the analysis results were then visualized using &#x201c;ggplots2&#x201d;. We obtained high-throughput expression data of cancer and normal tissues from the TCGA (<xref ref-type="bibr" rid="B22">22</xref>) and GETx databases (<uri xlink:href="http://commonfund.nih.gov/GTEx">http://commonfund.nih.gov/GTEx</uri>), respectively, and evaluated the correlation between genes in various tumors and various normal tissues to further illustrate the correlation between central genes.</p>
</sec>
<sec id="s3_9">
<title>The association between genes and transcription factors</title>    <p>Transcription factors are involved in various complex biological processes by regulating the transcription process through specific DNA sequence recognition. RNA-seq data were obtained from TCGA database and we used ChEA3 (<uri xlink:href="https://maayanlab.cloud/chea3/">https://maayanlab.cloud/chea3/</uri>) database to identify the transcription factors of hub gene and demonstrated them using Cytoscape software.</p>
</sec>
<sec id="s3_10">
<title>Gene set enrichment analysis</title>    <p>A gene set&#x2019;s significance between two biological states can be determined using gene set enrichment analysis (GSEA) (<xref ref-type="bibr" rid="B23">23</xref>). A single gene GSEA analysis was carried out to better investigate the potential mechanism through which Hub genes affect RA. At the same time, h.all.v7.5.1.symbols.gmt in the Molecular Signatures Database (MSigDB: <uri xlink:href="https://www.gsea-msigdb.org/gsea/index.jsp">https://www.gsea-msigdb.org/gsea/index.jsp</uri>) was selected as the reference gene set, and Spearman rank correlation coefficient was obtained by using the package &#x201c;corrplot&#x201d;, and adjustment P value &lt;0.05 was used as the screening criterion.</p>
</sec>
<sec id="s3_11">
<title>Construction of protein-protein interaction network</title>    <p>GeneMANIA (<uri xlink:href="http://genemania.org/">http://genemania.org/</uri>), a website for creating protein-protein interaction (PPI) networks, may be used to make predictions for the functions of genes and find genes with similar effects. Among them, providing physical interaction, co-expression, co-localization, gene enrichment analysis, genetic interaction, and locus prediction are some of the bioinformatics methods used by network integration algorithms.</p>
</sec>
</sec>
<sec id="s4" sec-type="results">
<title>Results</title>
<sec id="s4_1">
<title>RA gene expression data acquisition and evaluation of immune cells infiltration</title>
<p>Microarray expression data of rheumatoid arthritis (GSE55235) were downloaded from the GEO database, and genes with a variation coefficient greater than 0.1 were selected for subsequent analysis. We next used the R package &#x201c;CIBERSORT&#x201d; to analyze the corresponding expression data in the dataset GSE55235 to ascertain the percentage of various immune cell subtypes in each sample from the dataset. The proportion of each block&#x2019;s seven T cell subtypes was then chosen as the trait data for the WGCNA.</p>
</sec>
<sec id="s4_2">
<title>Construction of WGCNA co-expression network</title>
<p>Based on genes with a variation coefficient greater than 0.1 from the GSE55235 dataset, the R package &#x201c;WGCNA&#x201d; was used to construct a gene co-expression network. The average association coefficient and Pearson correlation coefficient were then calculated, and cluster analysis on all samples in the dataset was performed. A scale-first network was built using &#x3b2;=7 as the soft threshold rate (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1A, B</bold>
</xref>). To create hierarchical clustering trees, the dynamic hybrid cutting technique was employed. Each branch is a module that combines all genes with similar expression levels, and each leaf represents a gene (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1C, D</bold>
</xref>). Functionally equivalent modules were then combined into one large module, resulting in 37 modules (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1E, F</bold>
</xref>, <xref ref-type="fig" rid="f2">
<bold>2A</bold>
</xref>).</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Construction of WGCNA co-expression network. <bold>(A)</bold> Sample clustering dendrogram with tree leaves corresponding to individual samples. <bold>(B)</bold> Soft threshold &#x3b2; = 7 and scale-free topological fit index (R2). <bold>(C)</bold> Clustered dendrograms were cut at a height of 0.25 to detect and combine similar modules. <bold>(D)</bold> Shows the original and combined modules under the clustering tree. <bold>(E)</bold> Collinear heat map of module feature genes. Red color indicates a high correlation, blue color indicates the opposite results. <bold>(F)</bold> Clustering dendrogram of module feature genes.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g001.tif"/>
</fig>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>module&#x2013;trait correlations and Functional enrichment analysis <bold>(A)</bold> Heat map of module&#x2013;trait correlations. Red represents positive correlations and blue represents negative correlations. <bold>(B)</bold> Module Membership in the blue module. <bold>(C)</bold> GO analysis. <bold>(D)</bold> KEGG analysis.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g002.tif"/>
</fig>
</sec>
<sec id="s4_3">
<title>Hub module identification and function enrichment analysis</title>
<p>Among the 37 modules, the blue module had the most significant relationship with CD8+T cell (R<sup>2 =</sup> 0.69, P=2E-05). We designate the blue module as the hub module as a result. In this module, potentially important genes that are most closely related to CD8+ T cells were shown to have a stronger correlation. Gene with gene significance &gt;0.75 were selected as candidate central genes, and a total of 10 genes (NKG7, CD8A, DHRS9, CCL5, IL2RG, TNS3, PARP12, GZMA, PRF1, CYTH4) were selected (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>).</p>
<p>The genes in the blue module were then subjected to GO/KEGG analysis. The findings demonstrated that genes for immune response-activating cell surface receptor signaling pathway, antigen receptor-mediated signaling pathway, and T cell activation in BP were highly enriched in the blue module. The external side of the plasma membrane, MHC protein complex, and secretory membrane were significantly enriched in CC. While cytokine receptor activity, MHC protein complex binding, and SH2 domain binding were significantly enriched in MF (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2C</bold>
</xref>). Module genes were significantly enriched in Epstein-Barr virus infection, Chemokine signaling pathway, Antigen processing, and presentation in KEGG (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2D</bold>
</xref>).</p>
</sec>
<sec id="s4_4">
<title>Screening and identification of hub genes</title>
<p>We performed LASSO and random forest analysis on the above-mentioned 10 genes, and a total of 6 genes (NKG7, CD8A, TNS3, PARP12, GZMA, PRF1) were obtained by LASSO analysis (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Genes of Importance &gt;0.6 were selected from RF analysis results for analysis (CD8A, DHRS9, CCL5, IL2RG, TNS3, GZMA, PRF1)(<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>). Next, a Venn diagram was used to visualize the intersection genes of LASSO and RF, and a total of 4 genes (CD8A, TNS3, GZMA, PRF1) were found (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3C</bold>
</xref>). GSE55235 (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A&#x2013;C</bold>
</xref>), GSE55457 (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4D&#x2013;F</bold>
</xref>), GSE55584 (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4G&#x2013;I</bold>
</xref>), GSE1919 and GSE48780 (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4J&#x2013;L</bold>
</xref>) were used to identify and validate the correlation between the levels of CD8A, TNS3, GZMA, PRF1, and CD8+ T-cell infiltration. CD8A, GZMA, and PRF1 were identified as reliable Hub genes. The results of the analysis revealed that three genes were significantly positively correlated with the degree of CD8+ T-cell infiltration in these data sets. At the same time, we selected different cancers for analysis (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>). CIBERSORT, McP-counter, QUANTISEQ, TIMER, and XCELL were employed to explore the expression values of genes related to CD8+T cells in different cancers and utilized the &#x201c;ggPlot&#x201d; R package for visualization. It was discovered that CD8A (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>), GZMA (<xref ref-type="supplementary-material" rid="SF1">
<bold>Supplementary Figure&#xa0;1</bold>
</xref>), and PRF1 (<xref ref-type="supplementary-material" rid="SF1">
<bold>Supplementary Figure&#xa0;2</bold>
</xref>) were positively correlated with CD8+T cell infiltration in various malignancies. These analyses verified that the identified hub genes play a significant role in the tumor immune microenvironment and are highly correlated with the degree of CD8+ T-cell infiltration.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Hub gene selection. <bold>(A)</bold> Adjustment of feature selection in the minimum absolute shrinkage and selection operator model (lasso). <bold>(B)</bold> randomForest error rate versus the number of classification trees, the top 20 relatively important genes. <bold>(C)</bold> Three algorithmic Venn diagram screening genes.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g003.tif"/>
</fig>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>Scatter plots of hub gene expression versus CD8+ T cell infiltration levels in three different datasets: <bold>(A-C)</bold> GSE55235. <bold>(D-F)</bold> GSE55457. <bold>(G-I)</bold> GSE55584. <bold>(J-L)</bold> GSE1919 and GSE48780.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g004.tif"/>
</fig>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>The relationship between CD8A expression levels and the degree of CD8+ T cell infiltration in different cancers was statistically significant at P&lt;0.05: <bold>(A)</bold> CIBERSORT. <bold>(B)</bold> MCP-counter. <bold>(C)</bold> QUANTISEQ. <bold>(D)</bold> TIMER. <bold>(E)</bold> XCELL.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g005.tif"/>
</fig>
</sec>
<sec id="s4_5">
<title>Hub gene correlation</title>
<p>We verified the correlation between hub genes in different data sets and found that CD8A, GZMA, and PRF1 were significantly positively correlated with each other. The relationship between CD8A, GZMA, and PRF1 in various malignancies was then examined (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6</bold>
</xref>). Except for THYM, CD8A, and GZMA being positively correlated in all tumors, CD8A and PRF1 were positively correlated in 33 tumors, and GZMA and PRF1 were positively correlated in 33&#xa0;tumors (<xref ref-type="fig" rid="f7">
<bold>Figures&#xa0;7A&#x2013;C</bold>
</xref>). The results of normal tissue analysis showed that CD8A and GZMA were positively correlated in various normal tissues, GZMA and PRF1 were positively correlated in various normal tissues, CD8A and PRF1 were negatively correlated in Bone Marrow, and the rest were positively correlated (<xref ref-type="fig" rid="f7">
<bold>Figures&#xa0;7D&#x2013;F</bold>
</xref>).</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>Relationship between the expression levels of three hub genes in three different gene sets <bold>(A)</bold> GSE55235. <bold>(B)</bold> GSE55457. <bold>(C)</bold> GSE55584. <bold>(D)</bold> GSE1919 and GSE48780.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g006.tif"/>
</fig>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>Relationship between the expression levels of three hub genes. <bold>(A-C)</bold> In different cancer types. <bold>(D-F)</bold> In normal tissues.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g007.tif"/>
</fig>
</sec>
<sec id="s4_6">
<title>Transcription factor analysis</title>
<p>We identified 8 common transcription factors (EOMES, TBX21, STAT4, ZNF80, GFI1, SCML4, ZNF831, RUNX3) associated with CD8A, GZMA, and PRF1 from the CHEA3 database (<xref ref-type="fig" rid="f8">
<bold>Figure&#xa0;8</bold>
</xref>).</p>
<fig id="f8" position="float">
<label>Figure&#xa0;8</label>
<caption>
<p>Prediction of transcription factors of Hub gene in CHEA3 database.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g008.tif"/>
</fig>
</sec>
<sec id="s4_7">
<title>Gene enrichment</title>
<p>To explore the function of the hub gene, we carried out a single gene GSEA analysis. It was found that CD8A was mainly enriched in Rheumatoid arthritis, Asthma, Cholesterol metabolism, etc (<xref ref-type="fig" rid="f9">
<bold>Figure&#xa0;9A</bold>
</xref>). GZEA is mainly enriched in cholesterol metabolism, steroid biosynthesis, mineral absorption, etc (<xref ref-type="fig" rid="f9">
<bold>Figure&#xa0;9B</bold>
</xref>). PRF1 was mainly enriched in Coronavirus disease COVID-19, the Pentose phosphate pathway, and Linoleic acid metabolism (<xref ref-type="fig" rid="f9">
<bold>Figure&#xa0;9C</bold>
</xref>). We then used h.all.v7.5.1.symbols. gmt as a reference gene set to analyze the correlation between genes and genomes. CD8A, GZMA, and PRF1 were found to be positively correlated with interferon gamma response, interferon alpha response, inflammatory response, il6 jak stat3 signaling, complement, and allograft rejection, and negatively with uv response dn, pancreas beta cells, myogensis, cholesterol homeostasis, androgen response, and adipogenesis.</p>
<fig id="f9" position="float">
<label>Figure&#xa0;9</label>
<caption>
<p>GSEA analysis of hub gene. <bold>(A)</bold> CD8A. <bold>(B)</bold> GZMB. <bold>(C)</bold> PRF1.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g009.tif"/>
</fig>
</sec>
<sec id="s4_8">
<title>Analysis of hub gene interaction</title>
<p>GeneMANIA database was employed to create PPI networks for Hub genes. To further investigate the function of hub genes, we constructed a 20-gene interaction network (<xref ref-type="fig" rid="f10">
<bold>Figure&#xa0;10A</bold>
</xref>). At the same time, 20 genes were investigated for functional enrichment. Results showed that, in BP, Genes were mainly enriched in T cell-mediated immunity, modification of morphology, or physiology of other organisms. Genes were mainly enriched in immunological synapses and the external side of the plasma membrane under CC. In MF, genes were mainly enriched in phospholipase activator activity and lipase activator activity (<xref ref-type="fig" rid="f10">
<bold>Figure&#xa0;10B</bold>
</xref>). Genes in the KEGG pathway may regulate Primary immunodeficiency, Viral protein interaction with cytokine, and cytokine receptor. These findings lead us to hypothesize those hub genes are crucial for the immune system (<xref ref-type="fig" rid="f10">
<bold>Figure&#xa0;10C</bold>
</xref>).</p>
<fig id="f10" position="float">
<label>Figure&#xa0;10</label>
<caption>
<p>Interaction analysis of Hub genes. <bold>(A)</bold> Characterized gene co-expression network. <bold>(B)</bold> GO analysis of co-expressed genes. <bold>(C)</bold> Co&#x2013;expressed gene KEGG analysis.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-1044909-g010.tif"/>
</fig>
</sec>
</sec>
<sec id="s5" sec-type="discussion">
<title>Discussion</title>
<p>RA is a chronic progressive autoimmune disease with an increasing incidence that cause great damage to patients&#x2019; exercise and labor ability. But unfortunately, there are still no effective intervention measures in clinical practice, and there is also a lack of precise diagnosis and treatment methods. A large number of previous studies have shown that CD8+ T cells play an extremely important role in the progression of RA and the clinical outcome of patients (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B24">24</xref>). Based on this, genes in the GSE55235 dataset were combined with WGCNA and a variety of machinery. The learning algorithm finally obtained three core genes closely related to CD8+ T cells, namely CD8A, GZMA, and PRF1. We further performed validation and analysis on these three genes.</p>
<p>Interestingly, we found that these three core genes were mentioned in previous studies in RA, among which GZMA has the most relevant studies. GZMA is a member of the serine protease family, mainly derived from NK cells and T cells, and plays an important regulatory role in cell death and the release of inflammatory mediators (<xref ref-type="bibr" rid="B25">25</xref>). As early as a clinical study in 1999 (<xref ref-type="bibr" rid="B26">26</xref>), GZMA was found to be highly expressed in the serum and synovial tissue of RA patients, and in 2017, Llipsy Santiago et&#xa0;al. found in mice that knocking out GZMA can reduce osteoclasts. Active and efficient tissue production of collagen-induced arthritis in mice (a mouse model of RA) (<xref ref-type="bibr" rid="B27">27</xref>). More interestingly, the role of GZMA is not limited to RA. Abnormal expression of GZMA has been found in autoimmune diseases such as SLE and Sj&#xf6;gren&#x2019;s syndrome, which shows that the gene has a very objective intervention value (<xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B29">29</xref>). For CD8A, this gene is currently considered to be one of the key genes in the differential diagnosis and prognosis prediction of RA in the bioinformatics analysis conducted by several research teams (<xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B31">31</xref>), while the study by Cai-Yue Gao et&#xa0;al. found that knocking out the CD8A gene can promote the damage of salivary glands in Sj&#xf6;gren&#x2019;s syndrome mice, which may also be an important mechanism for resident CD8+ T cells to induce joint synovial damage in RA (<xref ref-type="bibr" rid="B32">32</xref>). PRF1 belongs to the perforin family of genes. The study by Lan Wang et&#xa0;al. showed that PRF1 is important for rheumatoid disease, while the study by Zoya Qaiyum et&#xa0;al. found the abnormal expression of this gene in the gene map of ankylosing spondylitis (<xref ref-type="bibr" rid="B33">33</xref>).</p>
<p>In addition, the relationship between these three key genes and 33 cancer species was also explored in this study. We found that the CD8A gene is positively associated with a variety of cancers, a result also confirmed by other research groups. For example, Chirag Krishna et&#xa0;al. found that in clear cell renal cell carcinoma, patients with high CD8A expression had more severe ICB resistance symptoms and tumor-associated macrophage infiltration (<xref ref-type="bibr" rid="B34">34</xref>); while Bruno Sangro et&#xa0;al. The CD8A gene is a good prognostic predictor in nivolumab-treated patients with advanced hepatocellular carcinoma (<xref ref-type="bibr" rid="B35">35</xref>). Similarly, Zhiwei Zhou et&#xa0;al. showed that GZMA can cleave GSDMB and induce tumor cell pyroptosis in an IFN-&#x3b3;-dependent manner (<xref ref-type="bibr" rid="B36">36</xref>). Moreover, PRF1 has also been shown to play a role in the prognosis and progression of various cancers including breast and colon cancer (<xref ref-type="bibr" rid="B37">37</xref>, <xref ref-type="bibr" rid="B38">38</xref>). These studies illustrate the important roles of these three genes in human diseases from another dimension.</p>
<p>Since our research is based on bioinformatics methods, it may be subject to the bias of the analysis results due to the quality of the samples in the database. Therefore, more <italic>in vivo</italic> or <italic>in vitro</italic> experiments are needed to further verify the results.</p>
</sec>
<sec id="s6" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>. Further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author contributions</title>
<p>ZZ and JR planned the research concept and designed it, made provisions for study material, collected data and analyzed them, and wrote and approved the manuscript. SX searched for data and wrote programming code. LZ and QZ collected pictures and graphs as well as wrote response letters. SZ and DZ collected data and analyzed them, wrote and approved, and helped correct the manuscript. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>This research is funded by the National Natural Science Foundation of China (Project number: 81901650), Shenzhen Key Laboratory of Musculoskeletal Tissue Reconstruction and Function Restoration and Shenzhen People&#x2019;s Hospital (Project number: ZDSYS20200811143752005), Guangzhou Science and Technology Project (Grant No. 201904010060, Effect and mechanism of S100A4 on collagen-induced arthritis (CIA) model in mice. National Natural Science Foundation of China (Project number:81401766), the fundamental research funds for the central universities (Project number:21619348), Funding by Science and Technology Projects in Guangzhou (Project number: 2021020200460).</p>
</sec>
<sec id="s9" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s10" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<sec id="s11" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fimmu.2022.1044909/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fimmu.2022.1044909/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet_1.docx" id="SF1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
<supplementary-material xlink:href="DataSheet_2.csv" id="SM1" mimetype="text/csv"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<label>1</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Smolen</surname> <given-names>JS</given-names>
</name>
<name>
<surname>Aletaha</surname> <given-names>D</given-names>
</name>
<name>
<surname>Barton</surname> <given-names>A</given-names>
</name>
<name>
<surname>Burmester</surname> <given-names>GR</given-names>
</name>
<name>
<surname>Emery</surname> <given-names>P</given-names>
</name>
<name>
<surname>Firestein</surname> <given-names>GS</given-names>
</name>
<etal/>
</person-group>. <article-title>Rheumatoid arthritis</article-title>. <source>Nat Rev Dis Primers</source> (<year>2018</year>) <volume>4</volume>:<fpage>18001</fpage>. doi: <pub-id pub-id-type="doi">10.1038/nrdp.2018.1</pub-id>
</citation>
</ref>
<ref id="B2">
<label>2</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Smolen</surname> <given-names>JS</given-names>
</name>
</person-group>. <article-title>Rheumatoid arthritis primer - behind the scenes</article-title>. <source>Nat Rev Dis Primers</source> (<year>2020</year>) <volume>6</volume>(<issue>1</issue>):<fpage>32</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41572-020-0168-y</pub-id>
</citation>
</ref>
<ref id="B3">
<label>3</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kumar</surname> <given-names>LD</given-names>
</name>
<name>
<surname>Karthik</surname> <given-names>R</given-names>
</name>
<name>
<surname>Gayathri</surname> <given-names>N</given-names>
</name>
<name>
<surname>Sivasudha</surname> <given-names>T</given-names>
</name>
</person-group>. <article-title>Advancement in contemporary diagnostic and therapeutic approaches for rheumatoid arthritis</article-title>. <source>BioMed Pharmacother</source> (<year>2016</year>) <volume>79</volume>:<fpage>52</fpage>&#x2013;<lpage>61</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.biopha.2016.02.001</pub-id>
</citation>
</ref>
<ref id="B4">
<label>4</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hyndman</surname> <given-names>IJ</given-names>
</name>
</person-group>. <article-title>Rheumatoid arthritis: Past, present and future approaches to treating the disease</article-title>. <source>Int J Rheum Dis</source> (<year>2017</year>) <volume>20</volume>(<issue>4</issue>):<page-range>417&#x2013;9</page-range>. doi: <pub-id pub-id-type="doi">10.1111/1756-185X.12823</pub-id>
</citation>
</ref>
<ref id="B5">
<label>5</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vos</surname> <given-names>T</given-names>
</name>
<name>
<surname>Allen</surname> <given-names>C</given-names>
</name>
<name>
<surname>Arora</surname> <given-names>M</given-names>
</name>
<name>
<surname>Barber</surname> <given-names>RM</given-names>
</name>
<name>
<surname>qar A Bhutta</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Brown</surname> <given-names>A</given-names>
</name>
<etal/>
</person-group>
<article-title>Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the global burden of disease study 2015</article-title>. <source>Lancet</source> (<year>2016</year>) <volume>388</volume>(<issue>10053</issue>):<page-range>1545&#x2013;602</page-range>. doi: <pub-id pub-id-type="doi">10.1016/S0140-6736(16)31678-6</pub-id>
</citation>
</ref>
<ref id="B6">
<label>6</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Smolen</surname> <given-names>JS</given-names>
</name>
<name>
<surname>Aletaha</surname> <given-names>D</given-names>
</name>
<name>
<surname>McInnes</surname> <given-names>IB</given-names>
</name>
</person-group>. <article-title>Rheumatoid arthritis</article-title>. <source>Lancet</source> (<year>2016</year>) <volume>388</volume>(<issue>10055</issue>):<page-range>2023&#x2013;38</page-range>. doi: <pub-id pub-id-type="doi">10.1016/S0140-6736(16)30173-8</pub-id>
</citation>
</ref>
<ref id="B7">
<label>7</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zander</surname> <given-names>R</given-names>
</name>
<name>
<surname>Schauder</surname> <given-names>D</given-names>
</name>
<name>
<surname>Xin</surname> <given-names>G</given-names>
</name>
<name>
<surname>Nguyen</surname> <given-names>C</given-names>
</name>
<name>
<surname>Wu</surname> <given-names>X</given-names>
</name>
<name>
<surname>Zajac</surname> <given-names>A</given-names>
</name>
<etal/>
</person-group>. <article-title>CD4(+) T cell help is required for the formation of a cytolytic CD8(+) T cell subset that protects against chronic infection and cancer</article-title>. <source>Immunity</source> (<year>2019</year>) <volume>51</volume>(<issue>6</issue>):<fpage>1028</fpage>&#x2013;<lpage>1042.e4</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.immuni.2019.10.009</pub-id>
</citation>
</ref>
<ref id="B8">
<label>8</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lees</surname> <given-names>JR</given-names>
</name>
</person-group>. <article-title>CD8+ T cells: The past and future of immune regulation</article-title>. <source>Cell Immunol</source> (<year>2020</year>) <volume>357</volume>:<fpage>104212</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.cellimm.2020.104212</pub-id>
</citation>
</ref>
<ref id="B9">
<label>9</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Fousteri</surname> <given-names>G</given-names>
</name>
<name>
<surname>Kuka</surname> <given-names>M</given-names>
</name>
</person-group>. <article-title>The elusive identity of CXCR5(+) CD8 T cells in viral infection and autoimmunity: Cytotoxic, regulatory, or helper cells</article-title>? <source>Mol Immunol</source> (<year>2020</year>) <volume>119</volume>:<page-range>101&#x2013;5</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.molimm.2020.01.007</pub-id>
</citation>
</ref>
<ref id="B10">
<label>10</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Carvalheiro</surname> <given-names>H</given-names>
</name>
<name>
<surname>da Silva</surname> <given-names>JA</given-names>
</name>
<name>
<surname>Souto Carneiro</surname> <given-names>MM</given-names>
</name>
</person-group>. <article-title>Potential roles for CD8(+) T cells in rheumatoid arthritis</article-title>. <source>Autoimmun Rev</source> (<year>2013</year>) <volume>12</volume>(<issue>3</issue>):<page-range>401&#x2013;9</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.autrev.2012.07.011</pub-id>
</citation>
</ref>
<ref id="B11">
<label>11</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chang</surname> <given-names>MH</given-names>
</name>
<name>
<surname>Levescot</surname> <given-names>A</given-names>
</name>
<name>
<surname>Nelson-Maney</surname> <given-names>N</given-names>
</name>
<name>
<surname>Blaustein</surname> <given-names>RB</given-names>
</name>
<name>
<surname>Winden</surname> <given-names>KD</given-names>
</name>
<name>
<surname>Morris</surname> <given-names>A</given-names>
</name>
<etal/>
</person-group>. <article-title>Arthritis flares mediated by tissue-resident memory T cells in the joint</article-title>. <source>Cell Rep</source> (<year>2021</year>) <volume>37</volume>(<issue>4</issue>):<fpage>109902</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.celrep.2021.109902</pub-id>
</citation>
</ref>
<ref id="B12">
<label>12</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Souto-Carneiro</surname> <given-names>MM</given-names>
</name>
<name>
<surname>Klika</surname> <given-names>KD</given-names>
</name>
<name>
<surname>Abreu</surname> <given-names>MT</given-names>
</name>
<name>
<surname>Meyer</surname> <given-names>AP</given-names>
</name>
<name>
<surname>Saffrich</surname> <given-names>R</given-names>
</name>
<name>
<surname>Sandhoff</surname> <given-names>R</given-names>
</name>
<etal/>
</person-group>. <article-title>Effect of increased lactate dehydrogenase a activity and aerobic glycolysis on the proinflammatory profile of autoimmune CD8+ T cells in rheumatoid arthritis</article-title>. <source>Arthritis Rheumatol</source> (<year>2020</year>) <volume>72</volume>(<issue>12</issue>):<page-range>2050&#x2013;64</page-range>. doi: <pub-id pub-id-type="doi">10.1002/art.41420</pub-id>
</citation>
</ref>
<ref id="B13">
<label>13</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Woetzel</surname> <given-names>D</given-names>
</name>
<name>
<surname>Huber</surname> <given-names>R</given-names>
</name>
<name>
<surname>Kupfer</surname> <given-names>P</given-names>
</name>
<name>
<surname>Pohlers</surname> <given-names>D</given-names>
</name>
<name>
<surname>Pfaff</surname> <given-names>M</given-names>
</name>
<name>
<surname>Driesch</surname> <given-names>D</given-names>
</name>
<etal/>
</person-group>. <article-title>Identification of rheumatoid arthritis and osteoarthritis patients by transcriptome-based rule set generation</article-title>. <source>Arthritis Res Ther</source> (<year>2014</year>) <volume>16</volume>(<issue>2</issue>):<fpage>R84</fpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1186/ar4526</pub-id>
</citation>
</ref>
<ref id="B14">
<label>14</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ungethuem</surname> <given-names>U</given-names>
</name>
<name>
<surname>Haeupl</surname> <given-names>T</given-names>
</name>
<name>
<surname>Witt</surname> <given-names>H</given-names>
</name>
<name>
<surname>Koczan</surname> <given-names>D</given-names>
</name>
<name>
<surname>Krenn</surname> <given-names>V</given-names>
</name>
<name>
<surname>Huber</surname> <given-names>H</given-names>
</name>
<etal/>
</person-group>. <article-title>Molecular signatures and new candidates to target the pathogenesis of rheumatoid arthritis</article-title>. <source>Physiol Genomics</source> (<year>2010</year>) <volume>42a</volume>(<issue>4</issue>):<page-range>267&#x2013;82</page-range>. doi: <pub-id pub-id-type="doi">10.1152/physiolgenomics.00004.2010</pub-id>
</citation>
</ref>
<ref id="B15">
<label>15</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sun</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Caplazi</surname> <given-names>P</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Mazloom</surname> <given-names>A</given-names>
</name>
<name>
<surname>Kummerfeld</surname> <given-names>S</given-names>
</name>
<name>
<surname>Quinones</surname> <given-names>G</given-names>
</name>
<etal/>
</person-group>. <article-title>PILR&#x3b1; negatively regulates mouse inflammatory arthritis</article-title>. <source>J Immunol</source> (<year>2014</year>) <volume>193</volume>(<issue>2</issue>):<page-range>860&#x2013;70</page-range>. doi: <pub-id pub-id-type="doi">10.4049/jimmunol.1400045</pub-id>
</citation>
</ref>
<ref id="B16">
<label>16</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ritchie</surname> <given-names>ME</given-names>
</name>
<name>
<surname>Phipson</surname> <given-names>B</given-names>
</name>
<name>
<surname>Wu</surname> <given-names>D</given-names>
</name>
<name>
<surname>Hu</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Law</surname> <given-names>CW</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>W</given-names>
</name>
<etal/>
</person-group>. <article-title>Limma powers differential expression analyses for RNA-sequencing and microarray studies</article-title>. <source>Nucleic Acids Res</source> (<year>2015</year>) <volume>43</volume>(<issue>7</issue>):<elocation-id>e47</elocation-id>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkv007</pub-id>
</citation>
</ref>
<ref id="B17">
<label>17</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Newman</surname> <given-names>AM</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>CL</given-names>
</name>
<name>
<surname>Green</surname> <given-names>MR</given-names>
</name>
<name>
<surname>Gentles</surname> <given-names>AJ</given-names>
</name>
<name>
<surname>Feng</surname> <given-names>W</given-names>
</name>
<name>
<surname>Xu</surname> <given-names>Y</given-names>
</name>
<etal/>
</person-group>. <article-title>Robust enumeration of cell subsets from tissue expression profiles</article-title>. <source>Nat Methods</source> (<year>2015</year>) <volume>12</volume>(<issue>5</issue>):<page-range>453&#x2013;7</page-range>. doi: <pub-id pub-id-type="doi">10.1038/nmeth.3337</pub-id>
</citation>
</ref>
<ref id="B18">
<label>18</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Langfelder</surname> <given-names>P</given-names>
</name>
<name>
<surname>Horvath</surname> <given-names>S</given-names>
</name>
</person-group>. <article-title>WGCNA: an r package for weighted correlation network analysis</article-title>. <source>BMC Bioinf</source> (<year>2008</year>) <volume>9</volume>:<fpage>559</fpage>. doi: <pub-id pub-id-type="doi">10.1186/1471-2105-9-559</pub-id>
</citation>
</ref>
<ref id="B19">
<label>19</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ishwaran</surname> <given-names>H</given-names>
</name>
<name>
<surname>Kogalur</surname> <given-names>UB</given-names>
</name>
</person-group>. <article-title>Consistency of random survival forests</article-title>. <source>Stat Probab Lett</source> (<year>2010</year>) <volume>80</volume>(<issue>13-14</issue>):<page-range>1056&#x2013;64</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.spl.2010.02.020</pub-id>
</citation>
</ref>
<ref id="B20">
<label>20</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Harris</surname> <given-names>MA</given-names>
</name>
<name>
<surname>Clark</surname> <given-names>JI</given-names>
</name>
<name>
<surname>Ireland</surname> <given-names>A</given-names>
</name>
<name>
<surname>Lomax</surname> <given-names>J</given-names>
</name>
<name>
<surname>Ashburner</surname> <given-names>M</given-names>
</name>
<name>
<surname>Collins</surname> <given-names>R</given-names>
</name>
<etal/>
</person-group>
<article-title>The gene ontology (GO) project in 2006</article-title>. <source>Nucleic Acids Res</source> (<year>2006</year>) <volume>34</volume>:<page-range>D322&#x2013;6</page-range>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkj021</pub-id>
</citation>
</ref>
<ref id="B21">
<label>21</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kanehisa</surname> <given-names>M</given-names>
</name>
<name>
<surname>Goto</surname> <given-names>S</given-names>
</name>
</person-group>. <article-title>KEGG: kyoto encyclopedia of genes and genomes</article-title>. <source>Nucleic Acids Res</source> (<year>2000</year>) <volume>28</volume>(<issue>1</issue>):<fpage>27</fpage>&#x2013;<lpage>30</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/28.1.27</pub-id>
</citation>
</ref>
<ref id="B22">
<label>22</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Blum</surname> <given-names>A</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>P</given-names>
</name>
<name>
<surname>Zenklusen</surname> <given-names>JC</given-names>
</name>
</person-group>. <article-title>SnapShot: TCGA-analyzed tumors</article-title>. <source>Cell</source> (<year>2018</year>) <volume>173</volume>(<issue>2</issue>):<fpage>530</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.cell.2018.03.059</pub-id>
</citation>
</ref>
<ref id="B23">
<label>23</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Subramanian</surname> <given-names>A</given-names>
</name>
<name>
<surname>Tamayo</surname> <given-names>P</given-names>
</name>
<name>
<surname>Mootha</surname> <given-names>VK</given-names>
</name>
<name>
<surname>Mukherjee</surname> <given-names>S</given-names>
</name>
<name>
<surname>Ebert</surname> <given-names>BL</given-names>
</name>
<name>
<surname>Gillette</surname> <given-names>MA</given-names>
</name>
<etal/>
</person-group>. <article-title>Gene set enrichment analysis: a knowledge-based approach for interpreting genome-wide expression profiles</article-title>. <source>Proc Natl Acad Sci U.S.A.</source> (<year>2005</year>) <volume>102</volume>(<issue>43</issue>):<page-range>15545&#x2013;50</page-range>. doi: <pub-id pub-id-type="doi">10.1073/pnas.0506580102</pub-id>
</citation>
</ref>
<ref id="B24">
<label>24</label>
<citation citation-type="journal">
<person-group person-group-type="author"><name>
<surname>Higashioka</surname> <given-names>K</given-names>
</name>
<name>
<surname>Yoshimura</surname> <given-names>M</given-names>
</name>
<name>
<surname>Sakuragi</surname> <given-names>T</given-names>
</name>
<name>
<surname>Ayano</surname> <given-names>M</given-names>
</name>
<name>
<surname>Kimoto</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Mitoma</surname> <given-names>H</given-names>
</name>
<etal/>
</person-group>. <article-title>Human PD-1(hi)CD8(+) T cells are a cellular source of IL-21 in rheumatoid arthritis</article-title>. <source>Front Immunol</source> (<year>2021</year>) <volume>12</volume>:<elocation-id>654623</elocation-id>. doi: <pub-id pub-id-type="doi">10.3389/fimmu.2021.654623</pub-id>
</citation>
</ref>
<ref id="B25">
<label>25</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Anthony</surname> <given-names>DA</given-names>
</name>
<name>
<surname>Andrews</surname> <given-names>DM</given-names>
</name>
<name>
<surname>Watt</surname> <given-names>SV</given-names>
</name>
<name>
<surname>Trapani</surname> <given-names>JA</given-names>
</name>
<name>
<surname>Smyth</surname> <given-names>MJ</given-names>
</name>
</person-group>. <article-title>Functional dissection of the granzyme family: cell death and inflammation</article-title>. <source>Immunol Rev</source> (<year>2010</year>) <volume>235</volume>(<issue>1</issue>):<fpage>73</fpage>&#x2013;<lpage>92</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.0105-2896.2010.00907.x</pub-id>
</citation>
</ref>
<ref id="B26">
<label>26</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tak</surname> <given-names>PP</given-names>
</name>
<name>
<surname>Spaeny-Dekking</surname> <given-names>L</given-names>
</name>
<name>
<surname>Kraan</surname> <given-names>MC</given-names>
</name>
<name>
<surname>Breedveld</surname> <given-names>FC</given-names>
</name>
<name>
<surname>Froelich</surname> <given-names>CJ</given-names>
</name>
<name>
<surname>Hack</surname> <given-names>CE</given-names>
</name>
<etal/>
</person-group>. <article-title>The levels of soluble granzyme a and b are elevated in plasma and synovial fluid of patients with rheumatoid arthritis (RA)</article-title>. <source>Clin Exp Immunol</source> (<year>1999</year>) <volume>116</volume>(<issue>2</issue>):<page-range>366&#x2013;70</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.1046/j.1365-2249.1999.00881.x</pub-id>
</citation>
</ref>
<ref id="B27">
<label>27</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Santiago</surname> <given-names>L</given-names>
</name>
<name>
<surname>Menaa</surname> <given-names>C</given-names>
</name>
<name>
<surname>Arias</surname> <given-names>M</given-names>
</name>
<name>
<surname>Martin</surname> <given-names>P</given-names>
</name>
<name>
<surname>Jaime-S&#xe1;nchez</surname> <given-names>P</given-names>
</name>
<name>
<surname>Metkar</surname> <given-names>S</given-names>
</name>
<etal/>
</person-group>. <article-title>Granzyme a contributes to inflammatory arthritis in mice through stimulation of osteoclastogenesis</article-title>. <source>Arthritis Rheumatol</source> (<year>2017</year>) <volume>69</volume>(<issue>2</issue>):<page-range>320&#x2013;34</page-range>. doi: <pub-id pub-id-type="doi">10.1002/art.39857</pub-id>
</citation>
</ref>
<ref id="B28">
<label>28</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tsubota</surname> <given-names>K</given-names>
</name>
<name>
<surname>Saito</surname> <given-names>I</given-names>
</name>
<name>
<surname>Miyasaka</surname> <given-names>N</given-names>
</name>
</person-group>. <article-title>Granzyme a and perforin expressed in the lacrimal glands of patients with sj&#xf6;gren's syndrome</article-title>. <source>Am J Ophthalmol</source> (<year>1994</year>) <volume>117</volume>(<issue>1</issue>):<page-range>120&#x2013;1</page-range>. doi: <pub-id pub-id-type="doi">10.1016/S0002-9394(14)73032-6</pub-id>
</citation>
</ref>
<ref id="B29">
<label>29</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Maehara</surname> <given-names>T</given-names>
</name>
<name>
<surname>Mattoo</surname> <given-names>H</given-names>
</name>
<name>
<surname>Ohta</surname> <given-names>M</given-names>
</name>
<name>
<surname>Mahajan</surname> <given-names>VS</given-names>
</name>
<name>
<surname>Moriyama</surname> <given-names>M</given-names>
</name>
<name>
<surname>Yamauchi</surname> <given-names>M</given-names>
</name>
<etal/>
</person-group>. <article-title>Lesional CD4+ IFN-&#x3b3;+ cytotoxic T lymphocytes in IgG4-related dacryoadenitis and sialoadenitis</article-title>. <source>Ann Rheum Dis</source> (<year>2017</year>) <volume>76</volume>(<issue>2</issue>):<page-range>377&#x2013;85</page-range>. doi: <pub-id pub-id-type="doi">10.1136/annrheumdis-2016-209139</pub-id>
</citation>
</ref>
<ref id="B30">
<label>30</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhou</surname> <given-names>S</given-names>
</name>
<name>
<surname>Lu</surname> <given-names>H</given-names>
</name>    <name>
<surname>Xiong</surname> <given-names>M</given-names>
</name>
</person-group>. <article-title>Identifying immune cell infiltration and effective diagnostic biomarkers in rheumatoid arthritis by bioinformatics analysis</article-title>. <source>Front Immunol</source> (<year>2021</year>) <volume>12</volume>:<elocation-id>726747</elocation-id>. doi: <pub-id pub-id-type="doi">10.3389/fimmu.2021.726747</pub-id>
</citation>
</ref>
<ref id="B31">
<label>31</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Long</surname> <given-names>NP</given-names>
</name>
<name>
<surname>Park</surname> <given-names>S</given-names>
</name>
<name>
<surname>Anh</surname> <given-names>NH</given-names>
</name>
<name>
<surname>Min</surname> <given-names>JE</given-names>
</name>
<name>
<surname>Yoon</surname> <given-names>SJ</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>HM</given-names>
</name>
<etal/>
</person-group>. <article-title>Efficacy of integrating a novel 16-gene biomarker panel and intelligence classifiers for differential diagnosis of rheumatoid arthritis and osteoarthritis</article-title>. <source>J Clin Med</source> (<year>2019</year>) <volume>8</volume>(<issue>1</issue>):<elocation-id>50</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/jcm8010050</pub-id>
</citation>
</ref>
<ref id="B32">
<label>32</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gao</surname> <given-names>CY</given-names>
</name>
<name>
<surname>Yao</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Li</surname> <given-names>L</given-names>
</name>
<name>
<surname>Yang</surname> <given-names>SH</given-names>
</name>
<name>
<surname>Chu</surname> <given-names>H</given-names>
</name>
<name>
<surname>Tsuneyama</surname> <given-names>K</given-names>
</name>
<etal/>
</person-group>. <article-title>Tissue-resident memory CD8+ T cells acting as mediators of salivary gland damage in a murine model of sj&#xf6;gren's syndrome</article-title>. <source>Arthritis Rheumatol</source> (<year>2019</year>) <volume>71</volume>(<issue>1</issue>):<page-range>121&#x2013;32</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.1002/art.40676</pub-id>
</citation>
</ref>
<ref id="B33">
<label>33</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Qaiyum</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Gracey</surname> <given-names>E</given-names>
</name>
<name>
<surname>Yao</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Inman</surname> <given-names>RD</given-names>
</name>
</person-group>. <article-title>Integrin and transcriptomic profiles identify a distinctive synovial CD8+ T cell subpopulation in spondyloarthritis</article-title>. <source>Ann Rheum Dis</source> (<year>2019</year>) <volume>78</volume>(<issue>11</issue>):<page-range>1566&#x2013;75</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.1136/annrheumdis-2019-215349</pub-id>
</citation>
</ref>
<ref id="B34">
<label>34</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Krishna</surname> <given-names>C</given-names>
</name>
<name>
<surname>DiNatale</surname> <given-names>RG</given-names>
</name>
<name>
<surname>Kuo</surname> <given-names>F</given-names>
</name>
<name>
<surname>Srivastava</surname> <given-names>RM</given-names>
</name>
<name>
<surname>Vuong</surname> <given-names>L</given-names>
</name>
<name>
<surname>Chowell</surname> <given-names>D</given-names>
</name>
<etal/>
</person-group>. <article-title>Single-cell sequencing links multiregional immune landscapes and tissue-resident T cells in ccRCC to tumor topology and therapy efficacy</article-title>. <source>Cancer Cell</source> (<year>2021</year>) <volume>39</volume>(<issue>5</issue>):<fpage>662</fpage>&#x2013;<lpage>677.e6</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.ccell.2021.03.007</pub-id>
</citation>
</ref>
<ref id="B35">
<label>35</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sangro</surname> <given-names>B</given-names>
</name>
<name>
<surname>Melero</surname> <given-names>I</given-names>
</name>
<name>
<surname>Wadhawan</surname> <given-names>S</given-names>
</name>
<name>
<surname>Finn</surname> <given-names>RS</given-names>
</name>
<name>
<surname>Abou-Alfa</surname> <given-names>GK</given-names>
</name>
<name>
<surname>Cheng</surname> <given-names>AL</given-names>
</name>
<etal/>
</person-group>. <article-title>Association of inflammatory biomarkers with clinical outcomes in nivolumab-treated patients with advanced hepatocellular carcinoma</article-title>. <source>J Hepatol</source> (<year>2020</year>) <volume>73</volume>(<issue>6</issue>):<page-range>1460&#x2013;9</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.jhep.2020.07.026</pub-id>
</citation>
</ref>
<ref id="B36">
<label>36</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhou</surname> <given-names>Z</given-names>
</name>
<name>
<surname>He</surname> <given-names>H</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>K</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>X</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Su</surname> <given-names>Y</given-names>
</name>
<etal/>
</person-group>. <article-title>Granzyme a from cytotoxic lymphocytes cleaves GSDMB to trigger pyroptosis in target cells</article-title>. <source>Science</source> (<year>2020</year>) <volume>368</volume>(<issue>6494</issue>):<elocation-id>eaaz7548</elocation-id>. doi: <pub-id pub-id-type="doi">10.1126/science.aaz7548</pub-id>
</citation>
</ref>
<ref id="B37">
<label>37</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bassez</surname> <given-names>A</given-names>
</name>
<name>
<surname>Vos</surname> <given-names>H</given-names>
</name>
<name>
<surname>Van Dyck</surname> <given-names>L</given-names>
</name>
<name>
<surname>Floris</surname> <given-names>G</given-names>
</name>
<name>
<surname>Arijs</surname> <given-names>I</given-names>
</name>
<name>
<surname>Desmedt</surname> <given-names>C</given-names>
</name>
<etal/>
</person-group>. <article-title>A single-cell map of intratumoral changes during anti-PD1 treatment of patients with breast cancer</article-title>. <source>Nat Med</source> (<year>2021</year>) <volume>27</volume>(<issue>5</issue>):<page-range>820&#x2013;32</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41591-021-01323-8</pub-id>
</citation>
</ref>
<ref id="B38">
<label>38</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tosolini</surname> <given-names>M</given-names>
</name>
<name>
<surname>Kirilovsky</surname> <given-names>A</given-names>
</name>
<name>
<surname>Mlecnik</surname> <given-names>B</given-names>
</name>
<name>
<surname>Fredriksen</surname> <given-names>T</given-names>
</name>
<name>
<surname>Mauger</surname> <given-names>S</given-names>
</name>
<name>
<surname>Bindea</surname> <given-names>G</given-names>
</name>
<etal/>
</person-group>. <article-title>Clinical impact of different classes of infiltrating T cytotoxic and helper cells (Th1, th2, treg, th17) in patients with colorectal cancer</article-title>. <source>Cancer Res</source> (<year>2011</year>) <volume>71</volume>(<issue>4</issue>):<page-range>1263&#x2013;71</page-range>. doi: <pub-id pub-id-type="doi">10.1158/0008-5472.CAN-10-2907</pub-id>
</citation>
</ref>
</ref-list>
</back>
</article>