RESEARCH - Circulating cytokines in active polymyalgia rheumatica

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Ann Rheum Dis. Published Online First: 1 March 2009.

doi:10.1136/ard.2008.103663

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Extended Report

Circulating cytokines in active Polymyalgia Rheumatica

Alvarez-Rodríguez 1, Marcos -Hoyos 2, Cristina Mata 3,

María J Marín 1, Calvo-Alen 3, Blanco 1, Elena

Aurrecoechea 3, María Ruiz-Soto 1 and Víctor M Martínez-Taboada 1*

1 Servicio Reumatología. Hospital Universitario Marqués de Valdecilla, Spain

2 Servicio Inmunología. Hospital Universitario Marqués de Valdecilla, Spain

3 Servicio Reumatología. Hospital Sierrallana, Spain

Abstract

Objective: To characterize the circulating cytokine profile and the

cellular source of circulating cytokines in polymyalgia rheumatica

(PMR).

Methods: The study included 34 patients with active untreated PMR and

17 age-matched healthy controls (HC). Circulating cytokines were

measured by CBA and ELISA. Intracellular cytokines were assessed in

CD3+ and CD14+ cells by flow cytometry. Cytokines in cell culture

supernatants were also determined after polyclonal stimulation of

patient’s PBMC.

Results: Circulating levels of IL-6 were significantly higher in

active PMR compared to HC. Corticosteroid (CS) treatment was followed

by a decrease of IL-6. Intracellular cytokine staining showed that

circulating monocytes did not produce higher amounts of

proinflammatory cytokines in PMR patients than in HC. There was a

discordance between serum levels and cytokine-producing monocyte and T

cells and we were not able to demonstrate a Th1 bias in the peripheral

compartment.

Conclusion: Active PMR is characterized by increased serum levels of

IL-6, but not of other pro-inflammatory cytokines, that are rapidly

suppressed by CS therapy. Probably, as circulating monocytes do not

show increased production of proinflammatory cytokines, IL-6 might be

mainly produced in the inflamed tissue. The study of the circulating

cytokine profile and its cellular source may provide a clue to new

therapeutic options.

http://ard.bmj.com/cgi/content/abstract/ard.2008.103663v1

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