Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/50835
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Type: Journal article
Title: Modulation of RANKL and osteoprotegerin expression in synovial tissue from patients with rheumatoid arthritis in response to disease-modifying antirheumatic drug treatment and correlation with radiologic outcome
Author: Haynes, D.
Crotti, T.
Weedon, H.
Slavotinek, J.
Au, V.
Coleman, M.
Roberts-Thomson, P.
Ahern, M.
Smith, M.
Citation: Arthritis and Rheumatism, 2008; 59(7):911-920
Publisher: Wiley-Liss
Issue Date: 2008
ISSN: 0004-3591
1529-0131
Statement of
Responsibility: 
David Haynes, Tania Crotti, Helen Weedon, John Slavotinek, Virginia Au, Mark Coleman, Peter J. Roberts-Thomson, Michael Ahern, and Malcolm D. Smith
Abstract: Objective To demonstrate the effect of treatment with disease-modifying agents on the expression of osteoprotegerin (OPG) and RANKL in the synovial tissue from rheumatoid arthritis (RA) patients and to correlate these changes with radiologic damage measured on sequential radiographs of the hands and feet. Methods Synovial biopsy specimens were obtained at arthroscopy from 25 patients with active RA (16 of whom had a disease duration <12 months) before and at 3–6-month intervals after starting treatment with a disease-modifying agent. Immunohistologic analysis was performed using monoclonal antibodies to detect OPG and RANKL expression, with staining quantitated using computer-assisted image analysis and semiquantitative analysis techniques. Serial radiographs of the hands and feet were analyzed independently by 2 radiologists and a rheumatologist using the van der Heide modification of the Sharp scoring method. Results Thirteen patients achieved a low disease state as defined by a disease activity score <2.6 while 19 patients achieved an American College of Rheumatology response >20% after disease-modifying antirheumatic drug (DMARD) treatment. Successful DMARD treatment resulted in an increase in OPG expression and a decrease in RANKL expression at the synovial tissue level, which correlated with a reduction in erosion scores measured on annual radiographs of the hands and feet. Conclusion Successful treatment-induced modulation of OPG and RANKL expression at the synovial tissue level, resulting in a reduction in the RANKL:OPG ratio, is likely to have a significant impact on osteoclast formation and joint damage in patients with active RA.
Keywords: Synovial Membrane; Knee Joint; Humans; Arthritis, Rheumatoid; Antirheumatic Agents; Severity of Illness Index; Follow-Up Studies; Aged; Aged, 80 and over; Middle Aged; Female; Male; RANK Ligand; Osteoprotegerin
Description: The definitive version may be found at www.wiley.com Article first published online: 24 JUN 2008
Rights: Copyright © 2008, American College of Rheumatology
RMID: 0020082515
DOI: 10.1002/art.23818
Appears in Collections:Pathology publications

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