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Cytokine Key In Clinical Activity In Rheumatoid Arthritis

Synovial expression of macrophage migration inhibitory factor is strongly correlated with clinical disease activity in patients with rheumatoid arthritis.

This finding from a joint study in Australia and the United States adds significant weight to evidence for the importance of this cytokine's role in rheumatoid arthritis (RA).

In fact, migration inhibitory factor is an important member of the cytokine hierarchy in this disease, suggest these researchers from Monash Medical Centre, Melbourne, Repatriation General Hospital, Adelaide, and Picower Institute for Medical Research, Manhasset, New York.

Cytokines are known to be key in the pathology of RA, and MIF is one with a broad spectrum of actions. These include induction of monocyte tumour necrosis factor a (TNF-a).

MIF expression and proinflammatory activity in RA synovium and in animal models of the disease has been demonstrated recently. However, E. F. Morand and colleagues sought to assess the link between synovial MIF and clinical disease.

Using paired sample from eight patients with active and inactive/treated disease, the researchers compared computer-assisted analysis of cytokine content of arthroscopically obtained biopsies of RA synovium with documented clinical parameters.

Synovial MIF immunostaining correlated strongly with disease activity as measured by CRP concentration.

Moreover, significant reductions in synovial MIF were found to accompany reductions in clinical disease parameters, including CRP, and tender and swollen joint counts.

Synovial TNF-a, transforming growth factor b (TGF-b) and interleukin (IL)10 also showed a significant reduction in association with reduced disease activity; IL-1b and IL-1 receptor agonist did not.

The demonstration that only MIF and TNF-a show significant variation in synovial cytokine content with clinical remission points to MIF' s importance in the cytokine hierarchy in RA, these authors conclude.
Rheumatology 2002; 41: 558-562. "Macrophage migration inhibitory factor in rheumatoid arthritis: clinical correlations"

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