Background Disregulated apoptosis of T lymphocytes was postulated as one of the potential patomechanisms of rheumatoid arthritis. In peripheral blood of RA patients atypical clones of T cells were identified, overexpressing Bcl-2 protein and apoptosis resistant. Experimental treatment inducing apoptosis of joint infiltrating T cells and synovial fibroblasts resulted in disease remission in animal models.
Objectives The objective of the study was to examine the expression of apoptosis regulatory proteins (p53, Bcl-2, Bax and Fas) in peripheral blood and synovial fluid lymphocytes as well as sFas concentrations in patients with RA and to compare it with expression in other arthritides. We analized the correlation with disease clinical characteristics and treatment. The other aim was to determine the relation of those markers expression in blood and synovial fluid lymphocytes from the same patients.
Methods Study covered 77 RA patients, 18 OA patients 10 patients with other arthritides and healthy control group. Immunocytochemical analysis was performed with indirect immunoperoxidase test. sFas concentration was measured with ELISA test.
Results In RA patients with advanced joint destruction and active disease high overexpression of Bcl-2 was found (over 80%of cells) which correlated to ESR (r = 0.63, p = 0.027). Bcl-2 expression was significantly higher in RA patients with limited disease than in pts with extra articular disease (p = 0.02) No significant difference in other apoptosis markers expression among examined groups was found. We did not observe its relation to disease duration, RF seropositivity, clinical stage or treatment. Serum sFas concentration was significantly higher in extra articular RA (p = 0.009).
Conclusion The above results may indirectly suggest the role of lymphocyte apoptosis defect in RA pathogenesis, which demands further investigation.
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