Background Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by synovial tissue proliferation and degradation of articular cartilage. Activated synovial fibroblasts proliferate and express matrix-degrading proteases, adhesion molecules and proinflammatory cytokines, which contribute to cartilage and joint destruction. Moreover, synovial cell activation correlates with infiltration of inflammatory lymphocytes and monocytes which in turn contribute to synoviocyte activation, thus further exacerbating inflammation.

Objectives The functional relationship linking fibroblasts and T lymphocytes in this complex microenvironment has yet to be characterised. Therefore, we established an in vitro model to examine the outcomes of co-culturing activated human CD4 T cells with RA synovial fibroblasts.

Methods Co-culture assays were carried out using immortalised K4IM RA synovial fibroblasts or synovial fibroblast cells derived from arthroscopy biopsies of RA patients. Human CD4 T cells were stained with a proliferation-tracking dye and co-cultured with pre-seeded synovial fibroblasts for 5 days. The resulting cell cultures and supernatants were examined for proliferation, cytokine production, secretion of matrix metalloproteinases and expression of adhesion molecules.

Results We found that CD4 T cells and K4IM cells reciprocally induced an increased expression of adhesion molecules ICAM and VCAM. Furthermore, co-culture of CD4 T cells and synovial fibroblasts resulted in proliferation of CD4 T cells expressing increased levels of the proinflammatory cytokines IFN-γ and IL-17a and RANKL after 5 days. Lastly, co-culture of T cells and synovial fibroblasts resulted in secretion of IL-6, IL-8, IFN-γ and IL-17a and matrix metalloproteinases MMP-1 and MMP-3.

Conclusions These results indicate that CD4 T cells work mutually with synoviocytes to create an inflammatory microenvironment likely to promote joint destruction. Future studies will characterise the role of glucose metabolism in these cells and investigate if metabolism is intrinsically coupled to effector functions in these cells.

Disclosure of Interest None declared