CONCISE REPORT

Circulating tumour necrosis factor and soluble tumour necrosis factor receptors in patients with different patterns of rheumatoid synovitis

P A Klimiuk¹, S Sierakowski¹, R Latosiewicz², J P Cylwik³, B Cylwik³, J Skowronski² and J Chwiecko¹

¹ Department of Rheumatology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland
² Department of Orthopaedic Surgery, Medical University of Bialystok, Bialystok, Poland
³ Department of Clinical Pathomorphology, Medical University of Bialystok, Bialystok, Poland

Correspondence to:
Correspondence to:
Dr P A Klimiuk, Department of Rheumatology and Internal Diseases, Medical University of Bialystok, M. C. Sklodowskiej 24a, 15–276 Bialystok, Poland;
klimp{at}amb.edu.pl

Objective: To examine the relation between the serum levels of tumour necrosis factor (TNF), soluble tumour necrosis factor receptors (sTNF-R), and the histological pattern of rheumatoid synovitis.

Methods: An enzyme linked immunosorbent assay (ELISA) was used to measure TNF, p55 sTNF-R, and p75 sTNF-R concentrations in the serum of 43 patients with rheumatoid arthritis (RA) and 34 patients with osteoarthritis (OA).

Results: Upon histological analysis two variants of rheumatoid synovitis emerged. Twenty six RA specimens presented only diffuse infiltrates of mononuclear cells. In the remaining 17 samples the formation of lymphocytic follicles with germinal centre-like structures was found. Serum concentrations of TNF, p55 and p75 sTNF-R were raised in patients with RA compared with the OA control group (p<0.001 for all comparisons). Levels of TNF, p55 and p75 sTNF-R were higher in the serum of patients with RA with follicular synovitis than in patients with diffuse synovitis (p<0.001, p<0.01, and p<0.05, respectively). Serum concentrations of TNF, p55 and p75 sTNF-R correlated with markers of disease activity.

Conclusion: Different histological types of rheumatoid synovitis associated with distinct serum levels of TNF and sTNF-R reflect varying clinical activity of the disease and support the concept of RA heterogeneity.

Keywords: tumour necrosis factor ; tumour necrosis factor receptors; rheumatoid arthritis; histology

Abbreviations: CRP, C reactive protein; DAS, disease activity score; ELISA, enzyme linked immunosorbent assay; ESR, erythrocyte sedimentation rate; OA, osteoarthritis; RA, rheumatoid arthritis; RF, rheumatoid factor; sTNF-R, soluble tumour necrosis factor receptor; TNF, tumour necrosis factor

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