Quantitative determination of steroid hormone receptor positive cells in the synovium of patients with rheumatoid arthritis and osteoarthritis: is there a link to inflammation?
- 1Laboratory of Experimental Rheumatology and Neuroendocrino-Immunology, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
- 2Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
- 3Division of Rheumatology, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
- Correspondence to:
Dr R H Straub
Department of Internal Medicine I, University Hospital, Regensburg 93042, Germany;
- Accepted 17 June 2006
- Published Online First 30 June 2006
Background: Steroid hormone receptors such as glucocorticoid receptors, androgen receptors, and oestrogen receptors α (ERα) and β (ERβ) 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+), ERα+ and ERβ+ 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+, ERα+ and ERβ+ 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 ERα+ and ERβ+ 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.
- AR+, androgen receptor positive
- ERα+, oestrogen receptor α positive
- ERβ+, oestrogen receptor β positive
- GR+, gluco-corticoid receptor positive
Published Online First 30 June 2006
Competing interests: None.