Different cytokine profiles in patients with chronic and acute reactive arthritis

Abstract

Objective. Analysis of cytokine production in patients with acute and chronic reactive arthritis (AcReA/ChrReA) in order to search for new treatment possibilities. Methods. Cytokine production by peripheral blood and synovial fluid mononuclear cells (PBMCs/SFMCs) of 28 patients with AcReA, 27 patients with ChrReA, 26 patients with rheumatoid arthritis (RA) and 31 healthy controls was analysed by enzyme-linked immunosorbent assay (ELISA) and flow-cytometry. Production of tumour necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin (IL)-10 was measured by ELISA, while the percentages of TNF-α-, IFN-γ- and IL-4-positive CD3+ cells were determined in the same groups of patients and healthy subjects using flow cytometry. Results. Spontaneous TNF-α production observed in PBMCs of ChrReA, but not of AcReA, patients was significantly higher (P<0.001) than in healthy controls. The percentages of TNF-α-positive CD3+ blood cells in ChrReA exceeded that of RA patients and healthy controls (P< 0.05 and P<0.001, respectively). Also, the percentages of IFN-γ -positive CD3+ cells were significantly higher in peripheral blood and synovial fluid of ChrReA patients (P<0.05 and P<0.05, respectively as compared with AcReA. In ChrReA spontaneous IL-10 production in PBMCs was similar to that observed in healthy controls, while in RA and AcReA the production of IL-10 was significantly increased (P<0.05 and P< 0.05, respectively). IL-4 production was low in all study groups with no significant differences detected. Conclusions. High production of TNF-α and IFN-γ detected in ChrReA supports the possible use of anti-TNF-α treatment in ChrReA. © British Society for Rheumatology 2004; all rights reserved.