Background The blocking of IL-6 therapy is not effective treatment of ankylosing spondylitis (AS) in recent report, but the role of blocking IL-6 on peripheral joint in non-radiographic axial AS is unknown.
Objectives we studied the blocking of IL-6 in peripheral arthritis of non-radiographic axial AS via Toll like receptors.
Methods Synovial fibroblast (FLS) were obtained from knee of eight non-radiographic axial AS patients who were high BASDAI score (>6), and six RA patients who were moderate DAS28 score (>3.2). The expression of IL-6 was analyzed by real-time polymerase chain reaction and multiplex secretary protein analysis technology, Bio-plex assay, also the expression of toll like receptor (TLR) in FLS was detected by western blot.
Results The expression of TLR 2 and TLR 4 were observed on AS and RA FLS. The administration of peptidoglycan for TLR 2 and LPS for TLR 4 increased the level of IL-6 in AS and RA FLS. The treatment of AS FLS with IL-6 inhibitor, tocilizumab, resulted in reduced expression of TLR 2 and TLR 4 in AS FLS and re-administration of peptidoglycan for TLR 2 and LPS for TLR 4 treatment did not increased the expression of IL-6, TLR 2 and TLR 4 in AS FLS.
Conclusions Our results suggest that IL-6 maybe crucial role in peripheral arthritis of non-radiographic axial AS and blocking of IL-6 may ameliorate peripheral arthritis of AS by regulating TLR 2 and TLR 4, so inhibition of IL-6 maybe a potential therapeutic strategy in peripheral arthritis of non-radiographic axial AS.
Treatment of non-radiographic axial spondyloarthritis: it is only the beginning. Ann Rheum Dis June 2013 Vol 72 No 6
Disclosure of Interest None declared
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