RESEARCH - Quantitative determination of steroid hormone receptor positive cells in RA and OA

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ls of the Rheumatic Diseases 2007;66:53-58

© 2007 by BMJ Publishing Group Ltd & European League Against Rheumatism

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EXTENDED REPORT

Quantitative determination of steroid hormone receptor positive cells in the

synovium of patients with rheumatoid arthritis and osteoarthritis: is there

a link to inflammation?

S Capellino1, B Riepl1, L Rauch1, P Angele2, M Cutolo3 and R H Straub1

1 Laboratory of Experimental Rheumatology and Neuroendocrino-Immunology,

Department of Internal Medicine I, University Hospital Regensburg,

Regensburg, Germany

2 Department of Trauma Surgery, University Hospital Regensburg, Regensburg,

Germany

3 Division of Rheumatology, Department of Internal Medicine and Medical

Specialties, University of Genoa, Genoa, Italy

Background: Steroid hormone receptors such as glucocorticoid receptors,

androgen receptors, and oestrogen receptors (ER) and ß (ERß) have been

identified in synovial cells of patients with rheumatoid arthritis and

osteoarthritis.

Objectives: To find a quantitative relationship between the number of

receptor positive cells and markers of inflammation, and to compare the two

groups of patients with rheumatoid arthritis and osteoarthritis.

Methods: A total of 36 patients with rheumatoid arthritis (n = 17) and

osteoarthritis (n = 19) were included, and receptor positive cells and

cellular markers of synovial inflammation were quantified by

immunohistochemistry and ELISA (interleukin 6 (IL6) and IL8).

Results: Patients with rheumatoid arthritis showed a higher degree of

histologically determined inflammation compared with those with

osteoarthritis. However, synovial density of gluco-corticoid receptor

positive (GR+), androgen receptor positive (AR+), ER+ and ERß+ cells were

not different among patients with rheumatoid arthritis and osteoarthritis.

In patients with osteoarthritis, the density of GR+ cells positively

correlated with the density of AR+, ER+ and ERß+ cells (p = 0.007), which

was not observed in patients with rheumatoid arthritis. This indicates

positively coupled steroid hormone receptor expression in patients with

osteoarthritis but not in those with rheumatoid arthritis. In patients with

rheumatoid arthritis, secretion of synovial IL6 and IL8 positively

correlated with the density of ER+ and ERß+ cells (not with gluco-corticoid

receptor and androgen receptor), which was not found in the synovium of

patients with osteoarthritis. This indicates that inflammatory factors might

up regulate the expression of oestrogen receptors in patients with

rheumatoid arthritis, or vice versa.

Conclusions: In patients with osteoarthritis, expression of different

steroid receptors is positively coupled, which was not observed in the

synovium of patients with rheumatoid arthritis. This uncoupling phenomenon

in rheumatoid arthritis might lead to an imbalance of the normal synovial

homeostasis.

http://ard.bmj.com/cgi/content/abstract/66/1/53?etoc

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