Effects of pulse methylprednisolone on inflammatory mediators in peripheral blood, synovial fluid, and synovial membrane in rheumatoid arthritis

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dc.contributor.authorYoussef, P.
dc.contributor.authorHaynes, D.
dc.contributor.authorTriantafillou, S.
dc.contributor.authorParker, A.
dc.contributor.authorGamble, J.
dc.contributor.authorRoberts-Thomson, P.
dc.contributor.authorAhern, M.
dc.contributor.authorSmith, M.
dc.date.issued1997
dc.description.abstract<h4>Objective</h4>To establish whether the clinical efficacy of pulse methylprednisolone (MP; 1,000 mg intravenously) is related to the modulation of proinflammatory cytokines within the peripheral blood, synovial membrane, or synovial fluid compartments.<h4>Methods</h4>Eighteen patients with active rheumatoid arthritis (RA) were studied. Peripheral blood (11 patients) and knee synovial fluid (9 patients, 10 knees) were obtained before and at 4 and 24 hours after MP therapy. Interleukin-1beta (IL-1beta), IL-8, and tumor necrosis factor alpha (TNFalpha) were measured by enzyme-linked immunosorbent assay and biologic assays; prostaglandin E2 (PGE2) was measured by competitive radioimmunoassay. In 10 patients, arthroscopically directed synovial biopsies were obtained before and at 24 hours after treatment, at disease relapse (4 patients), and after retreatment (1 patient). Membranes were stained by immunohistochemical techniques with monoclonal antibodies against TNFalpha, IL-8, IL-1beta, and the IL-1 receptor antagonist protein (IL-1Ra).<h4>Results</h4>MP therapy was associated with a rapid (within 24 hours) and substantial decrease in the expression of TNFalpha in the lining and sublining regions of the synovial membrane, as well as substantial decreases in the levels of TNFalpha in serum and synovial fluid. There was also reduced IL-8 expression in the synovial lining, as well as reduced synovial fluid IL-8 levels. No effect on synovial membrane IL-1beta and IL-1Ra or synovial fluid IL-1beta and PGE2 was found.<h4>Conclusion</h4>MP therapy rapidly reduces IL-8 and TNFalpha levels in the synovial compartment, with cytokine changes in the serum and synovial fluid reflecting the changes in the synovial membrane. Alterations in TNFalpha expression in the synovial membrane correlated with clinical response to, and subsequent relapse after, MP therapy.
dc.description.statementofresponsibilityPeter P. Youssef, David R. Haynes, Sophie Triantafillou, Angela Parker, Jenny R. Gamble, Peter J. Roberts-Thomson, Michael J. Ahern and Malcolm D. Smith
dc.identifier.citationArthritis and Rheumatism, 1997; 40(8):1400-1408
dc.identifier.doi10.1002/art.1780400807
dc.identifier.issn0004-3591
dc.identifier.issn1529-0131
dc.identifier.urihttp://hdl.handle.net/2440/5519
dc.language.isoen
dc.publisherWILEY
dc.source.urihttps://doi.org/10.1002/art.1780400807
dc.subjectSynovial Membrane
dc.subjectSynovial Fluid
dc.subjectHumans
dc.subjectArthritis, Rheumatoid
dc.subjectMethylprednisolone
dc.subjectTumor Necrosis Factor-alpha
dc.subjectAnti-Inflammatory Agents, Non-Steroidal
dc.subjectInterleukin-8
dc.subjectInjections, Intravenous
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.titleEffects of pulse methylprednisolone on inflammatory mediators in peripheral blood, synovial fluid, and synovial membrane in rheumatoid arthritis
dc.typeJournal article
pubs.publication-statusPublished

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