title: Application of a new immunohistology scoring system (IH score): analysis of TNF-α in synovium related to disease activity score in infliximab-treated patients with rheumatoid arthritis.
abstract: OBJECTIVE
  This study aimed to analyze the relationship between the expression of tumor necrosis factor alpha (TNF-α) or interleukin-6 (IL-6) in synovium and the disease activity score (DAS) 28 (C-reactive protein, CRP) in treatment of infliximab for rheumatoid arthritis (RA).
  
  
  METHODS
  Synovial tissues were obtained from 16 infliximab-treated patients and assessed for TNF-α and IL-6 with a new immunohistology (IH) scoring system. The validation of IH score was performed and applied for the analysis of correlation between synovial TNF-α or IL-6 and DAS28 (CRP) in addition to Rooney score.
  
  
  RESULTS
  The IH score had high internal validity; the IH score of TNF-α strongly correlated with serum CRP and matrix metalloprotease-3 (MMP-3), as well as DAS28 (CRP) and the Rooney score. IL-6 did not correlate with DAS28 (CRP).
  
  
  CONCLUSIONS
  This study indicates that the IH score is useful as a new procedure to assess the cytokine expression easily and TNF-α in synovium correlates with disease activity in patients with RA treated with infliximab.
authors.affiliation: Department of Orthopaedic Surgery, Tokyo Women's Medical University , Medical Center East, Tokyo , Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Kanbe
authors.forename: Ryota
authors.initials: R
authors.lastname: Hara
authors.forename: Junji
authors.initials: J
authors.lastname: Chiba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Inoue
authors.forename: Masashi
authors.initials: M
authors.lastname: Taguchi
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D000069285:Infliximab; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012720:Severity of Illness Index; D013583:Synovial Membrane / Q000378:metabolism* / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab
keywords: Histology; Infliximab; Rheumatoid arthritis; Synovium; TNF-α