RESEARCH - Serum cytokines and steroidal hormones in PMR and elderly-onset RA

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Ann Rheum Dis. 2006 Apr 27; [Epub ahead of print]

Serum cytokines and steroidal hormones in polymyalgia rheumatica and

elderly-onset rheumatoid arthritis.

Cutolo M, Montecucco CM, Cavagna L, Caporali R, Capellino S, Montagna P,

Fazzuoli L, Villaggio B, Seriolo B, Sulli A.

Division of Rheumatology, Department of Internal Medicine, University

Hospital San o, Genoa, Italy.

BACKGROUND: Polymyalgia rheumatica (PMR) may create some difficulties in the

differential diagnosis with elderly-onset rheumatoid arthritis (EORA), as

well as with EORA with PMR-like onset (EORA/PMR). Aim: To investigate

possible differences between three groups of patients concerning serum

levels of inflammatory cytokines and steroidal hormones at baseline, and

after one month of glucocorticoid (GC) therapy (prednisone 7.5-12.5 mg/day).

PATIENTS AND METHODS: Fourteen PMR, fifteen EORA, and fourteen EORA/PMR

patients, as well as 15 healthy matched-control subjects were analyzed.

Tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-1

receptor antagonist (IL-1Ra), cortisol, dehydroepiandrosterone sulphate

(DHEAS), and 17-OH- progesterone (PRG) were evaluated. RESULTS: Both

TNF-alpha and IL-6 serum levels were found significantly higher in all three

groups of patients versus controls (p<0.01). IL-6 serum levels were found

significantly higher in both PMR and EORA/PMR patients versus EORA patients

(p<0.05). IL-1Ra serum levels were found significantly higher in EORA

patients versus controls (p<0.0001) and both PMR and EORA/PMR patients

(p<0.05). DHEAS was found significantly lower in EORA/PMR versus EORA

patients (p<0.05). PRG was found significantly higher in all patient groups

(p<0.05). Following GC treatment, TNF-alpha and IL-6 serum levels

significantly decreased in all patient groups; IL- 1Ra significantly

increased in both PMR and EORA/PMR patients; cortisol, DHEAS, as well as PRG

significantly decreased again in PMR and in EORA/PMR patients (p<0.05).

CONCLUSIONS: Different cytokine and steroidal hormone patterns suggest that

both PMR and EORA/PMR patients seem to be characterized by a more intensive

inflammatory reaction and are more efficient responders to the GC treatment,

than the EORA patients.

PMID: 16644782

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6644782

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