title: Interleukin-6 signalling in juvenile idiopathic arthritis is limited by proteolytically cleaved soluble interleukin-6 receptor.
abstract: OBJECTIVE
  Interleukin-6 (IL-6) exerts multiple effects on chondrocytes and fibroblasts within the joint and is associated with disease activity in juvenile idiopathic arthritis (JIA). Although these cells express the ubiquitous signalling receptor for all IL-6-related cytokines, gp130, they do not express a cognate IL-6 receptor. Consequently, IL-6 responses within these cells occur via IL-6 trans-signalling relying on the presence of a soluble receptor (sIL-6R). Levels of sIL-6R in vivo are governed by either proteolytic cleavage (PC) of cognate receptor or by differential sIL-6R mRNA splicing (DS). The aim of this study was to evaluate the contribution of both isoforms to clinical parameters associated with IL-6 signalling in JIA.
  
  
  METHODS
  IL-6, sIL-6R and DS-sIL-6R were measured by ELISA in serum and synovial fluid (SF) samples from 86 JIA patients. These data were related to indicators of inflammation-erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and compared between patients stratified by subtype, age and disease duration.
  
  
  RESULTS
  SF IL-6 significantly correlated with general indicators of activity (ESR and CRP) and SF PC-sIL-6R to a lesser degree with CRP. When the IL-6:sIL-6R ratio was calculated as an indicator of the potential for IL-6 signalling within the joint, 33% of SF samples showed a ratio >1 indicating saturation of sIL-6R by IL-6. Mean DS-sIL-6R levels were 0.71 ng/ml, whereas PC-sIL-6R levels constituted the majority of sIL-6R at 20.89 ng/ml.
  
  
  CONCLUSIONS
  IL-6 trans-signalling within the joints of JIA patients is predominantly governed by the presence of PC-sIL-6R, and the data provided suggest that synovial levels of IL-6 and sIL-6R would be sufficient to drive IL-6 responses in chondrocytes and synovial fibroblasts.
authors.affiliation: Musculoskeletal Research Group, Medical School Cookson Building, University of Newcastle-upon-Tyne, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Peake
authors.forename: K
authors.initials: K
authors.lastname: Khawaja
authors.forename: A
authors.initials: A
authors.lastname: Myers
authors.forename: M A
authors.initials: MA
authors.lastname: Nowell
authors.forename: S A
authors.initials: SA
authors.lastname: Jones
authors.forename: A D
authors.initials: AD
authors.lastname: Rowan
authors.forename: T E
authors.initials: TE
authors.lastname: Cawston
authors.forename: H E
authors.initials: HE
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000276:immunology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008875:Middle Aged; D020033:Protein Isoforms / Q000032:analysis / Q000097:blood; D019947:Receptors, Interleukin-6 / Q000032:analysis* / Q000097:blood; D012720:Severity of Illness Index; D015398:Signal Transduction / Q000276:immunology; D012995:Solubility; D013582:Synovial Fluid / Q000276:immunology
chemical_list: D015850:Interleukin-6; D020033:Protein Isoforms; D019947:Receptors, Interleukin-6; D002097:C-Reactive Protein