RESUMEN
OBJECTIVE: To investigate the production of proinflammatory cytokines and expression of cell adhesion molecules in the rheumatoid nodule. METHODS: Cytokine content (tumor necrosis factor alpha [TNFalpha], interleukin-1beta [IL-1beta], and IL-1 receptor antagonist [IL-1Ra]), at the messenger RNA (mRNA) and protein levels, and cell adhesion molecule expression were studied in 16 rheumatoid nodules and 6 synovial membranes. RESULTS: Macrophages in the rheumatoid nodules contained TNFalpha, IL-1beta, and IL-1Ra mRNA and protein, particularly in perivascular cells of the stroma and in the palisading layer. All cell adhesion molecules studied were expressed in both the rheumatoid nodules and synovial membranes, with increased expression of E-selectin in the rheumatoid nodule compared with the synovial membrane, and with the absence of vascular cell adhesion molecule 1 expression on cells of the palisading layer in the rheumatoid nodule. CONCLUSION: The presence of similar proinflammatory cytokines and cell adhesion molecules in the rheumatoid nodule and synovial membrane suggests that similar pathogenic processes result in the chronic inflammation and tissue destruction in these lesions.
Asunto(s)
Nódulo Reumatoide/etiología , Adulto , Anciano , Anciano de 80 o más Años , Moléculas de Adhesión Celular/biosíntesis , Moléculas de Adhesión Celular/genética , Citocinas/biosíntesis , Citocinas/genética , Femenino , Humanos , Proteína Antagonista del Receptor de Interleucina 1 , Interleucina-1/biosíntesis , Macrófagos/química , Masculino , Persona de Mediana Edad , ARN Mensajero/análisis , Receptores de Interleucina/antagonistas & inhibidores , Nódulo Reumatoide/metabolismo , Nódulo Reumatoide/patología , Sialoglicoproteínas/biosíntesis , Sialoglicoproteínas/genética , Membrana Sinovial/metabolismo , Membrana Sinovial/patología , Factor de Necrosis Tumoral alfa/biosíntesisRESUMEN
The concentration of C-reactive protein (CRP) in sera from 70 patients with systemic lupus erythematosus (SLE) showed no correlation with commonly accepted laboratory indices of disease activity. Most patients had detectable serum CRP, but in some patients CRP was not found despite repeated testing. This absence of a CRP response did not appear to be related to medication. In some patients high levels of CRP were seen in the absence of infection. Measurement of serum CRP in SLE is unlikely to be useful in the laboratory diagnosis of disease activity.