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Expression and function of toll-like receptors in peripheral blood mononuclear cells of patients with polymyalgia rheumatica and giant cell arteritis
  1. Lorena Álvarez Rodríguez1,
  2. Marcos López-Hoyos2,
  3. Cristina Mata3,
  4. Ana Fontalba4,
  5. Jaime Calvo Alen3,
  6. María José Marín1,
  7. José Luis Fernández-Luna4,
  8. Jesús Aguero Balbín5,
  9. Maitane Aranzamendi Zaldunbide5,
  10. Ricardo Blanco1,
  11. Víctor M Martínez-Taboada1
  1. 1Servicio de Reumatología, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
  2. 2Servicio de Inmunología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
  3. 3Sección de Reumatología, Hospital de Sierrallana, Torrelavega, Cantabria, Spain
  4. 4Unidad de Genética Molecular, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
  5. 5Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
  1. Correspondence to Víctor M Martínez-Taboada, Facultad de Medicina, Rheumatology Division, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, Avda De Valdecilla s/n, 39008 Santander, Spain; vmartinezt{at}medynet.com

Abstract

Objective To investigate the expression and function of the Toll-like receptor (TLR) family in peripheral blood mononuclear cells (PBMCs) of patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA).

Methods The authors analysed 70 patients with PMR, 20 with GCA, and 24 healthy controls (HC). TLR expression was assessed by flow cytometry. TLR function was assessed by stimulating PBMCs with specific ligands.

Results A significantly increased expression of TLR7 in PBMCs of patients with active disease compared with HC was found. Despite increased expression of TLR7, circulating monocytes from patients showed a significantly lower in vitro response to TLR7 agonists. No amino acid substitutions predicted to be functionally damaging were found in TLR7. A normal response to specific TLR7 agonists in patients in complete remission eliminated a genetic defect. TLR expression and function were also affected to some degree in other diseases characterised by a strong acute phase response.

Conclusion These data suggest activation of TLR7 during the active phase of PMR and GCA which resolves with complete disease remission. Whether this finding is the consequence of the marked inflammatory process in these disorders or activation by natural ligands remains to be explored.

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Footnotes

  • Ethics approval This study was conducted with the approval of the Regional (Cantabria) Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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