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Absence of a classically activated macrophage cytokine signature in peripheral spondylarthritis, including psoriatic arthritis
Arthritis & Rheumatism, 04/06/09

Vandooren B et al. – Data show that the local inflammatory milieu is clearly different in spondylarthritis (SpA) vs RA peripheral arthritis. Synovitis in SpA, including that in PsA, is characterized by a selective decrease in M1-derived proinflammatory mediators, such as TNF-α and IL-1β.

Methods

Study to assess whether the differential infiltration with macrophage subsets was associated with a different local inflammatory milieu in SpA vs RA
Effect of SpA and RA synovial fluid (SF) on macrophage polarization was tested in vitro on normal PBMC
SF levels of classically activated macrophage (M1)-derived and alternatively activated macrophage (M2)-derived mediators were analyzed in:
- 47 pts with non-psoriatic SpA
- 55 with RA, and
- 15 with psoriatic arthritis (PsA)
Paired synovial biopsy samples were analyzed histologically

Results

SF from SpA pts promoted preferential expression of the M2 markers CD163 and CD200R in vitro, even if SF levels of the prototypical M2-polarizing factors were not increased vs RA SF
SpA synovitis displayed strongly reduced SF levels of M1-derived, but not M2-derived, mediators
SF levels of M1-derived mediators correlated well with peripheral joint inflammation in RA
However, neither these mediators nor IL-1α and IL-17 did so in SpA
Of interest, the SF cytokine profile in PsA, a more destructive subtype of SpA, was similar to that in non-psoriatic SpA

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