Synovial fluid levels of proinflammatory interleukins and their inter-relationships in elderly vs younger onset rheumatoid arthritis.
Elderly-onset rheumatoid arthritis (EORA) is thought to be different from younger-onset disease (YORA) for many reasons, including a more elevated acute phase response and a more abrupt onset; both events are mainly regulated by pro-inflammatory interleukins (ILs), in particular, IL-1, IL-6 and IL-8. To compare the synovial fluid (SF) levels of these ILs, and their relationship to local inflammation as well as the acute phase response, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) in the two RA subsets, we determined white blood cell (WBC) number, total protein (TP), IL-1beta, IL-6 and IL-8 concentrations in the SF of 50 patients, 15 with EORA and 35 with YORA. Both ESR and CRP were higher in EORA than in YORA. IL-6 was higher in SF of EORA (2111.37 +/- 1425.03 pg/mL) than YORA (1077.53 +/- 757.62 pg/mL, p = 0.002), while no difference was observed for SF IL-1beta and IL-8. There was a weak correlation between SF IL-6 and IL-1beta in EORA, whereas SF ILs and CRP and/or ESR did not show any correlation in both groups. Our study indicates that in EORA, as in other diseases occurring in the elderly, there are elevated levels of IL-6. Higher SF levels of IL-6 may be, at least in part, responsible for the different behavior of EORA with respect to YORA.
Division of Rheumatology, University of Padova, Italy.
L
L
Punzi
N
N
Bertazzolo
M
M
Pianon
E
E
Rizzi
P
P
Rossini
S
S
Todesco
D000210:Acute-Phase Reaction; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000503:physiopathology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000502:physiology*; D015850:Interleukin-6 / Q000378:metabolism; D007378:Interleukins / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D013582:Synovial Fluid / Q000502:physiology*
D018836:Inflammation Mediators; D015850:Interleukin-6; D007378:Interleukins; D002097:C-Reactive Protein