Release of cartilage and bone macromolecules into synovial fluid: differences between psoriatic arthritis and rheumatoid arthritis.
OBJECTIVE
To elucidate whether differences in the destructive tissue process in cartilage and bone in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) can be recognised by different release patterns of molecular fragments derived from joint tissue.


METHODS
Aggrecan, cartilage oligomeric matrix protein (COMP), and bone sialoprotein (BSP) were quantified by immunoassays in knee joint synovial fluid samples. These were obtained early in the disease course of patients with PsA and RA. At the time of arthrocentesis radiographs of their knee and hip joints were normal.


RESULTS
At follow up no destruction had developed in the knees and hips of most patients with PsA (n=18), whereas the patients with RA could be separated into one "destructive" group (n=18) and one "non-destructive" group (n=25). Patients with PsA had low synovial fluid aggrecan concentrations (p<0.001 v the RA destructive group) but high COMP concentrations (p<0.01 and p<0.05 v destructive and non-destructive RA groups, respectively). Consequently, the aggrecan/COMP ratio was lowest in the PsA group (p<0.001 and p<0.01 v the destructive and non-destructive RA group, respectively). The synovial fluid concentrations of BSP did not differ between the three patient groups.


CONCLUSIONS
The release pattern of aggrecan and COMP, reflecting cartilage turnover, differed between the PsA group and, particularly, the destructive RA group. This suggests that different pathophysiological mechanisms for cartilage involvement operate in these conditions, with different destructive potential. The BSP concentrations did not differ between the patients groups, which indicates similar levels of bone involvement.
Mânsson
B
B
Department of Rheumatology, Lund University, Lund, Sweden. bengt.mansson@reum.lu.se
Gülfe
A
A
Geborek
P
P
Heinegård
D
D
Saxne
T
T
D000328:Adult; D000368:Aged; D053674:Aggrecans; D015535:Arthritis, Psoriatic / Q000378:metabolism*; D001172:Arthritis, Rheumatoid / Q000378:metabolism*; D015415:Biomarkers; D001842:Bone and Bones / Q000378:metabolism*; D064236:Cartilage Oligomeric Matrix Protein; D002358:Cartilage, Articular / Q000378:metabolism*; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D058574:Integrin-Binding Sialoprotein; D007719:Knee Joint / Q000378:metabolism; D037181:Lectins, C-Type; D046911:Macromolecular Substances; D008297:Male; D064235:Matrilin Proteins; D008875:Middle Aged; D011509:Proteoglycans / Q000378:metabolism; D012795:Sialoglycoproteins / Q000378:metabolism; D013582:Synovial Fluid / Q000378:metabolism*
D053674:Aggrecans; D015415:Biomarkers; D064236:Cartilage Oligomeric Matrix Protein; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; C546871:IBSP protein, human; D058574:Integrin-Binding Sialoprotein; D037181:Lectins, C-Type; D046911:Macromolecular Substances; D064235:Matrilin Proteins; D011509:Proteoglycans; D012795:Sialoglycoproteins; C577553:TSP5 protein, human