EXTENDED REPORT

Resistin in rheumatoid arthritis synovial tissue, synovial fluid and serum

L enolt¹, D Housa², Z Vernerová², T Jirásek², R Svobodová¹, D Veigl³, K Anderlová⁴, U Müller-Ladner⁵, K Pavelka¹, M Haluzík⁴

¹ Institute of Rheumatology, 1st Medical Faculty, Charles University, Prague, Czech Republic
² Department of Pathology, 1st Medical Faculty, Charles University, Prague, Czech Republic
³ Clinic of Orthopaedic Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic
⁴ 3rd Department of Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic
⁵ University Hospital Giessen, Department of Internal Medicine and Rheumatology, Division of Rheumatology and Clinical Immunology, Giessen, Germany

Correspondence to:
Dr L enolt
Institute of Rheumatology, Na Slupi 4, 12850 Prague 2, Czech Republic; seno{at}revma.cz

Background: Resistin is a newly identified adipocytokine which has demonstrated links between obesity and insulin resistance in rodents. In humans, proinflammatory properties of resistin are superior to its insulin resistance-inducing effects.

Objectives: To assess resistin expression in synovial tissues, serum and synovial fluid from patients with rheumatoid arthritis, osteoarthritis and spondylarthropathies (SpA), and to study its relationship with inflammatory status and rheumatoid arthritis disease activity.

Methods: Resistin expression and localisation in synovial tissue was determined by immunohistochemistry and confocal microscopy. Serum and synovial fluid resistin, leptin, interleukin (IL)1ß, IL6, IL8, tumour necrosis factor , and monocyte chemoattractant protein-1 levels were measured. The clinical activity of patients with rheumatoid arthritis was assessed according to the 28 joint count Disease Activity Score (DAS28).

Results: Resistin was detected in the synovium in both rheumatoid arthritis and osteoarthritis. Staining in the sublining layer was more intensive in patients with rheumatoid arthritis compared with those with osteoarthritis. In rheumatoid arthritis, macrophages (CD68), B lymphocytes (CD20) and plasma cells (CD138) but not T lymphocytes (CD3) showed colocalisation with resistin. Synovial fluid resistin was higher in patients with rheumatoid arthritis than in those with SpA or osteoarthritis (both p<0.001). In patients with rheumatoid arthritis and SpA, serum resistin levels were higher than those with osteoarthritis (p<0.01). Increased serum resistin in patients with rheumatoid arthritis correlated with both CRP (r = 0.53, p<0.02), and DAS28 (r = 0.44, p<0.05), but not with selected (adipo) cytokines.

Conclusion: The upregulated resistin at local sites of inflammation and the link between serum resistin, inflammation and disease activity suggest a role for resistin in the pathogenesis of rheumatoid arthritis.

Abbreviations: DAS28, Disease Activity Score 28; DMARDs, disease-modifying antirheumatic drugs; SpA, spondylarthropathy; TNF, tumour necrosis factor

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