Effects of pulse methylprednisolone on cell adhesion molecules in the synovial membrane in rheumatoid arthritis. Reduced E-selectin and intercellular adhesion molecule 1 expression.
OBJECTIVE
To investigate the effects of a 1,000-mg intravenous pulse of methylprednisolone succinate (MP) on cell adhesion molecule expression on the synovial vascular endothelium in patients with rheumatoid arthritis (RA).


METHODS
Sequential arthroscopic biopsy samples were taken before and 24 hours after MP administration (10 patients) and at the time of RA flare (2 patients) and after retreatment with MP (1 patient). Immunoperoxidase staining for E-selectin (CD62E), P-selectin (CD62P), intercellular adhesion molecule 1 (ICAM-1; CD54) and platelet-endothelial cell adhesion molecule (PECAM; CD31) was performed, and the staining was quantified by color video image analysis.


RESULTS
MP caused a rapid (within 24 hours) and substantial decrease in the expression of E-selectin on the synovial vascular endothelium, with a smaller reduction in ICAM-1 expression on synovial vascular endothelium and the synovial lining. There were no similar effects on synovial membrane P-selectin or PECAM expression.


CONCLUSIONS
A potential mechanism by which MP impairs neutrophil trafficking into inflamed RA joints might be by reducing E-selectin, and possibly, ICAM-1, expression in the synovial membrane.
Youssef
P P
PP
Department of Clinical Immunology, Flinders Medical Centre, Bedford Park, South Australia.
Triantafillou
S
S
Parker
A
A
Coleman
M
M
Roberts-Thomson
P J
PJ
Ahern
M J
MJ
Smith
M D
MD
D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology*; D001706:Biopsy; D015815:Cell Adhesion Molecules / Q000096:biosynthesis*; D002465:Cell Movement / Q000187:drug effects / Q000502:physiology; D019040:E-Selectin / Q000096:biosynthesis; D004730:Endothelium, Vascular / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis; D007596:Joints / Q000473:pathology; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000494:pharmacology*; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D013583:Synovial Membrane / Q000737:chemistry*
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D018799:Intercellular Adhesion Molecule-1; D008776:Methylprednisolone Hemisuccinate