Expression of inflammatory cytokines and adhesion molecules in haemodialysis-associated amyloidosis.
BACKGROUND
The occurrence of various arthropathies including carpal-tunnel syndrome (CTS) in dialysis-associated amyloidosis, a condition caused by the deposition of beta 2 microglobulin (beta 2MG), has been emphasized for several years. We attempted to analyse the pathogenesis of CTS in haemodialysis-associated amyloidosis (HA).


METHODS
The expression of cell adhesion molecules and inflammatory cytokines in tenosynovial tissues was determined by using both reverse-transcriptase polymerase chain reaction (RT-PCR) and immunostaining.


RESULTS
There was a marked expression of ICAM-1, VCAM-1, E-selectin mRNAs together with increased mRNA expression of inflammatory cytokines (IL-1 beta, TNF alpha, IL-6 and MCP-1) in proliferating synovial tissues. ICAM-1 was expressed not only on vascular endothelial cells, but also on synovial cells. In contrast, both VCAM-1 and E-selectin were exclusively expressed on endothelial cells. Mononuclear cells bearing CD13, CD14, CD33 and HLA-DR with macrophage-like morphology were accumulated in the perivascular area and expressed VLA-4, LFA-1 and Mac-1. Moreover, synovial lining cells, vascular endothelial cells and infiltrated mononuclear cells expressed chemokines such as MCP-1 and MIP-1 alpha.


CONCLUSIONS
These data suggest that upregulated expression of inflammatory cytokines and adhesion molecules promotes activation and infiltration of macrophages causing CTS in haemodialysis-associated amyloidosis patients.
Inoue
H
H
Division of Immunological Diseases, Tokyo Medical and Dental University, Japan.
Saito
I
I
Nakazawa
R
R
Mukaida
N
N
Matsushima
K
K
Azuma
N
N
Suzuki
M
M
Miyasaka
N
N
D000686:Amyloidosis / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D015815:Cell Adhesion Molecules / Q000235:genetics / Q000378:metabolism*; D016207:Cytokines / Q000235:genetics / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D014158:Transcription, Genetic
D015815:Cell Adhesion Molecules; D016207:Cytokines; D012333:RNA, Messenger