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AB0087 Higher levels of th17/23, TH2 and proinflammatory cytokines levels in synovial fluid of rheumatoid arthritis compared with psoriatic arthritis
  1. J.D. Cañete1,
  2. R. Celis1,
  3. J. Ramirez1,
  4. J.L. Fernández-Sueiro2,
  5. V. Ruiz-Esquide1,
  6. M.V. Hernández1,
  7. R. Sanmartí1
  1. 1Arthritis Unit, Rheumatology Dpt, Hospital Clínic De Barcelona, Barcelona
  2. 2Reumatologia, Hospital Juan Canalejo, La Coruña, Spain

Abstract

Background Rheumatoid arthritis (RA) and Psoriatic arthritis (PsA) are two chronic inflamatory diseases mediated by the immune system with joints as main targets. Both diseases seem to exhibit a Th1/Th17 pattern, but studies including joint cytokines and clinical variables are scarse and inconclusive.

Objectives To compare concentrations of Th1, Th2, Th17/23 and other proinflammatory cytokines in Synovial fluid, as well as their relation with disease activity, between RA and PsA patients.

Methods Synovial fluid was obtained from a inflammed knee joint of RA and PsA patients. SF concentrations of Th1, Th2, Th17 and proinflammatory cytokines were determined by Quantibody® Human Th17 Array (RayBiotech, GA, USA). Clinical and biological data were collected at inclusion.

Results 82 RA and 48 PsA patients were included. 78% and 21% of them were women; mean age was 57 and 47.6 years; disease duration 10.2 and 9.3 years; DAS28 4.94 and 3.80 (p<0.001), respectively. No significant differences were found in systemic (CRP and ESR) and synovial (SF IL-6 levels and ST CD68+ macrophages/mm2) between both groups.

IL-17F, IL-21, IL-22 and IL-23 SF levels were significantly higher (p<0.001, p=0.01, p=0.02 and p<0.001, respectively) in RA patients compared with PsA patients. Also SF levels of IL-12p70, IL-10, TGFb1, IL-1 beta, TNFalpha, TNF-beta and CCL20 were significantly higher (p=0.03, p<0.001, p<0.001, p<0.001, p=0.04 and p<0.001, respectively) in RA than in PsA patients.

In RA, DAS28 correlated with IL-21 (p=0.008) and CCL20 (p=0.001) levels; CRP with IL-10 (p=0.043) and CCL-20 (p<0.001); ESR with IL-10 (p=0.006), IL-17 (p=0.006) and CCL20 (p<0.001); TJC and SJC correlated with IL-21 (p=0.041 and p=0.028) and CCL20 (p=0.021 and p=0.02); RF levels was correlated with IL-2 (p=0.034), IL-4 (p=0.044), IL-10 (p=0.048) and CCL20 (p=0.019), and CCP levels with IL-4 (p=0.025) and CCL20 (p=0.026).

In PsA, SF IL-17 levels correlated with SJC (p=0.026) and CRP levels (p=0.001), and IL-10 and CCL 20 levels with erosive disease (p=0.020 and p=0.006, respectively).

Conclusions SF Th17/23, CCL20 (a chemoskine attracting CCR6+ Th17 cells), Th2, and proinflammatory cytokines levels are all higher in RA patients compared with PsA patients matched by systemic and Synovial inflammation. IL-21 and CCL20 levels correlated with disease activity in RA, while in PsA IL-17 levels correlated with markers of systemic inflammation.

Disclosure of Interest None Declared

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