RESEARCH - Up-regulation of CCR2 on circulating monocytes is a potential predictor of MTX response in RA

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Ann Rheum Dis. 2006 Aug 11; [Epub ahead of print]

Up-regulation of CCR2 on circulating monocytes is a potential predictor of

methotrexate response in active chronic rheumatoid arthritis.

Ellingsen T, Hornung N, Moller BK, Poulsen JH, Stengaard-Pedersen K.

Aarhus University Hospital, Denmark.

OBJECTIVES: In active chronic rheumatoid arthritis (RA) to evaluate the

effect of methotrexate (MTX) on the density of CCR2 and CXCR3 on circulating

monocytes and the co-expression of CXCR3 and CCR2 on CD4+ T-lymphocytes.

METHODS: All 34 RA patients fulfilled the 1987 ARA criteria and were

followed for 16 weeks after starting MTX treatment. Peripheral blood

mononuclear cells were analyzed for CCR2 and CXCR3 density by three- colour

flow cytometry before initiation of MTX treatment and at week 12. RESULTS:

Twentytwo patients (65%) were non- responders, 12 patients (35%) responded

to MTX by ACR- 20% and 8 of these patients (24%) responded by ACR-50%. In

active RA before start of MTX treatment CCR2 density on circulating

monocytes, CD4+CXCR3+ and CD4+CXCR3- T- lymphocytes was enhanced compared to

controls. During 12 weeks of MTX-treatment the CCR2 density on monocytes

decreased significantly in the ACR-50% group but not in the ACR-20% and the

non-responder group. The increased CCR2 density on CD4+CXCR3+ and CD4+CXCR3-

T-lymphocytes was unaffected by the reduction in disease activity measured

in relation to MTX treatment. The percentage of both monocytes and

CD4+CXCR3+ and CD4+CXCR3- T- lymphocytes among the peripheral circulating

mononuclear cells did not change during MTX-treatment.

CONCLUSIONS: Active chronic RA is characterized by enhanced CCR2 density on

circulating monocytes and CD4+CXCR3+ and CD4+CXCR3- T-lymphocytes. During

MTX- treatment a decrease in CCR2 density on monocytes in the ACR-50%

responder group was associated with decreased disease activity. The enhanced

CCR2 density on CD4+CXCR3+ and CD4+CXCR3- T lymphocytes was uninfluenced by

MTX treatment and disease activity.

PMID: 16905577

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

6905577

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