title: Lactoferrin is a survival factor for neutrophils in rheumatoid synovial fluid.
abstract: OBJECTIVE
  Lactoferrin is an iron-binding protein that is released from activated neutrophils at sites of inflammation and has anti-microbial as well as anti-inflammatory properties. This study set out to determine whether lactoferrin can delay neutrophil apoptosis and could act as a survival factor for neutrophils in SF.
  
  
  METHODS
  Human peripheral blood and SF neutrophils were incubated with iron-free lactoferrin and apoptosis determined after 9 h. SF from patients with RA was added to isolated neutrophils, with or without immunodepletion of lactoferrin, and effects on neutrophil apoptosis determined. Levels of lactoferrin in SF were assessed and related to disease duration and markers of disease activity.
  
  
  RESULTS
  Iron-free lactoferrin significantly delayed apoptosis of peripheral blood neutrophils, in a concentration-dependent manner after 9 h in culture (P < 0.04). Lactoferrin could also delay apoptosis of neutrophils isolated from SF of patients with RA. SF from patients with established RA delayed apoptosis of peripheral blood neutrophils and this effect was significantly reduced by depletion of lactoferrin (P < 0.03). Lactoferrin levels in SF from patients with established RA did not correlate with disease severity, but did correlate with markers of inflammation (CRP) and with the presence of RF. SF from patients with arthritis of <12 weeks duration did not contain significant levels of lactoferrin.
  
  
  CONCLUSIONS
  Lactoferrin contributes to extended neutrophil survival in the rheumatoid joint in the established phase of RA but not in very early arthritis.
authors.affiliation: Rheumatology Research Group, MRC Centre for Immune Regulation, Institute of Biomedical Research, Birmingham University, Birmingham, UK.
authors.forename: S H
authors.initials: SH
authors.lastname: Wong
authors.forename: N
authors.initials: N
authors.lastname: Francis
authors.forename: H
authors.initials: H
authors.lastname: Chahal
authors.forename: K
authors.initials: K
authors.lastname: Raza
authors.forename: M
authors.initials: M
authors.lastname: Salmon
authors.forename: D
authors.initials: D
authors.lastname: Scheel-Toellner
authors.forename: J M
authors.initials: JM
authors.lastname: Lord
mesh_terms: D017209:Apoptosis / Q000187:drug effects; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D016207:Cytokines / Q000494:pharmacology; D006801:Humans; D007781:Lactoferrin / Q000032:analysis / Q000494:pharmacology*; D009504:Neutrophils / Q000187:drug effects*; D012217:Rheumatoid Factor / Q000097:blood; D013582:Synovial Fluid / Q000166:cytology / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein; D012217:Rheumatoid Factor; D007781:Lactoferrin