title: Macrophage migration inhibitory factor in rheumatoid arthritis: evidence of proinflammatory function and regulation by glucocorticoids.
abstract: OBJECTIVE
  Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine whose involvement in tumor necrosis factor alpha (TNFalpha) synthesis and T cell activation suggests a role in the pathogenesis of rheumatoid arthritis (RA). Antagonism of MIF is associated with marked inhibition of animal models of RA. Uniquely, MIF is inducible by low concentrations of glucocorticoids. We sought to investigate the expression of MIF in RA synovial tissue.
  
  
  METHODS
  MIF was demonstrated in human RA synovium by immunohistochemistry, flow cytometry, enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (RT-PCR). Regulation of MIF expression was investigated by treatment of cultured fibroblast-like synoviocytes (FLS) with interleukin-1beta (IL-1beta), TNFalpha, or interferon-gamma (IFNgamma), and dexamethasone (DEX). Mononuclear cell TNFalpha release after exposure to FLS-conditioned medium was measured by ELISA.
  
  
  RESULTS
  MIF was present in RA synovial lining CD14+ macrophages and FLS. Constitutive MIF messenger RNA (mRNA) expression was demonstrated by RT-PCR of RNA from unstimulated cultured RA FLS, which also released abundant MIF. Serum, synovial fluid, and FLS intracellular MIF were significantly higher in RA patients than in controls. Synoviocyte MIF was not increased by IL-1beta, TNFalpha, or IFNgamma. In contrast, DEX 10(-7)M significantly reduced synoviocyte MIF, while DEX 10(-10)-10(-12)M induced a significant increase in MIF and MIF mRNA. Peripheral blood mononuclear cell TNFalpha release was induced by culture in RA FLS-conditioned medium, and this induction was significantly abrogated by monoclonal anti-MIF antibody, suggesting that MIF is an upstream regulator of TNFalpha release.
  
  
  CONCLUSIONS
  These data represent the first demonstration of the cytokine MIF in human autoimmune disease and suggest MIF as a potential therapeutic target in RA.
authors.affiliation: Monash Medical Centre, Melbourne, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Leech
authors.forename: C
authors.initials: C
authors.lastname: Metz
authors.forename: P
authors.initials: P
authors.lastname: Hall
authors.forename: P
authors.initials: P
authors.lastname: Hutchinson
authors.forename: K
authors.initials: K
authors.lastname: Gianis
authors.forename: M
authors.initials: M
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Weedon
authors.forename: S R
authors.initials: SR
authors.lastname: Holdsworth
authors.forename: R
authors.initials: R
authors.lastname: Bucala
authors.forename: E F
authors.initials: EF
authors.lastname: Morand
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000378:metabolism*; D002478:Cells, Cultured; D016207:Cytokines / Q000494:pharmacology; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000494:pharmacology; D008213:Lymphocyte Activation; D008263:Macrophage Migration-Inhibitory Factors / Q000032:analysis* / Q000235:genetics; D008264:Macrophages / Q000378:metabolism; D009000:Monocytes / Q000378:metabolism; D012333:RNA, Messenger / Q000032:analysis / Q000187:drug effects; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013583:Synovial Membrane / Q000737:chemistry / Q000166:cytology; D013601:T-Lymphocytes / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000378:metabolism
chemical_list: D016207:Cytokines; D005938:Glucocorticoids; D008263:Macrophage Migration-Inhibitory Factors; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma