title: Circulating tumour necrosis factor alpha and soluble tumour necrosis factor receptors in patients with different patterns of rheumatoid synovitis.
abstract: OBJECTIVE
  To examine the relation between the serum levels of tumour necrosis factor alpha (TNFalpha), soluble tumour necrosis factor receptors (sTNF-R), and the histological pattern of rheumatoid synovitis.
  
  
  METHODS
  An enzyme linked immunosorbent assay (ELISA) was used to measure TNFalpha, p55 sTNF-R, and p75 sTNF-R concentrations in the serum of 43 patients with rheumatoid arthritis (RA) and 34 patients with osteoarthritis (OA).
  
  
  RESULTS
  Upon histological analysis two variants of rheumatoid synovitis emerged. Twenty six RA specimens presented only diffuse infiltrates of mononuclear cells. In the remaining 17 samples the formation of lymphocytic follicles with germinal centre-like structures was found. Serum concentrations of TNFalpha, p55 and p75 sTNF-R were raised in patients with RA compared with the OA control group (p<0.001 for all comparisons). Levels of TNFalpha, p55 and p75 sTNF-R were higher in the serum of patients with RA with follicular synovitis than in patients with diffuse synovitis (p<0.001, p<0.01, and p<0.05, respectively). Serum concentrations of TNFalpha, p55 and p75 sTNF-R correlated with markers of disease activity.
  
  
  CONCLUSIONS
  Different histological types of rheumatoid synovitis associated with distinct serum levels of TNFalpha and sTNF-R reflect varying clinical activity of the disease and support the concept of RA heterogeneity.
authors.affiliation: Department of Rheumatology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland. klimp@amb.edu.pl
authors.forename: P A
authors.initials: PA
authors.lastname: Klimiuk
authors.forename: S
authors.initials: S
authors.lastname: Sierakowski
authors.forename: R
authors.initials: R
authors.lastname: Latosiewicz
authors.forename: J P
authors.initials: JP
authors.lastname: Cylwik
authors.forename: B
authors.initials: B
authors.lastname: Cylwik
authors.forename: J
authors.initials: J
authors.lastname: Skowronski
authors.forename: J
authors.initials: J
authors.lastname: Chwiecko
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D012995:Solubility; D013583:Synovial Membrane / Q000473:pathology; D013585:Synovitis / Q000097:blood* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015415:Biomarkers; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha