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Elevated synovial expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in patients with septic arthritis or rheumatoid arthritis
  1. Christopher E Collins (chriscollinsmd{at}hotmail.com)
  1. University of Southern California and Washington Hospital Center, United States
    1. Dan T La (datala{at}hotmail.com)
    1. University of Southern California, United States
      1. Hai-Tao Yang (haitaoy{at}usc.edu)
      1. University of Southern California, United States
        1. Frédéric Massin (massin.fr{at}voila.fr)
        1. Nancy Université, France
          1. Sébastien Gibot (s.gibot{at}chu-nancy.fr)
          1. Nancy Université, France
            1. Gilbert Faure (gilbert.faure{at}medecine.uhp-nancy.fr)
            1. Nancy Université, France
              1. William Stohl (stohl{at}usc.edu)
              1. University of Southern California, United States

                Abstract

                Objective: To determine whether synovial expression of triggering receptor expressed on myeloid cells-1 (TREM-1) is up-regulated in patients with distinct types of inflammatory or non-inflammatory arthritis.

                Methods: Synovial fluid (SF) samples were analyzed for levels of soluble TREM-1 (sTREM-1, n = 132), tumor necrosis factor α (TNFα, n = 78), and leukocyte TREM 1 mRNA (n = 48). Synovial tissue from 4 rheumatoid arthritis (RA) patients, 2 patients with Crohn’s associated arthritis, 1 patient with ankylosing spondylitis (AS), and 1 patient with osteoarthritis (OA) were examined for TREM-1 expression by immunohistology, and 3 of the RA samples were also analyzed by Western blotting.

                Results: SF sTREM-1 levels in septic arthritis and RA were similar to each other and were each greater than those in gouty arthritis, non-septic/non-RA inflammatory arthritis, and non-inflammatory arthritis. SF TNFα and sTREM-1 levels correlated with each other, and sTREM-1 and leukocyte TREM-1 mRNA levels each correlated with SF leukocyte counts. TREM-1 in RA was expressed in situ in synovial tissue by cells of myelomonocytic lineage but was not detectably expressed in control OA synovial tissue.

                Conclusions: Synovial TREM-1 expression is increased in septic arthritis and RA. In patients with acute inflammatory arthritis, elevated SF sTREM 1 levels may point the clinician to a diagnosis of septic arthritis or RA. In RA patients, targeting TREM-1 may have therapeutic benefits by reducing local proinflammatory cytokine and chemokine release.

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