The Effect of Disease Activity Related Cytokines on the Fibrinolytic Potential and cICAM-1 Expression in Rheumatoid Arthritis

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A DGReview of : " The Effect of Disease Activity Related Cytokines on the

Fibrinolytic Potential and cICAM-1 Expression in Rheumatoid Arthritis "

Journal of Rheumatology

11/14/2000

By Rose

Two proinflammatory cytokines may contribute to the severity of rheumatoid

arthritis (RA). And, according to researchers, the anti-inflammatory cyctokine

interleukin (IL)-10 does little to counter this action.

Tumour necrosis factor a (TNF-a) and IL-6 may be implicated in the imbalance of

coagulation and fibrinolysis in favour of coagulation and the impairment of the

adhesive molecule pathway in RA.

Researchers studied the relationship between pro- and anti-inflammatory

cytokines to disease activity, coagulation and fibrinolytic variables and

circulating intercellular adhesive molecule-1 (cICAM-1). The study was designed

to provide a better understanding of the cascade of events, which are implicated

in the inflammatory process in rheumatoid arthritis.

Participants included 45 patients with rheumatoid arthritis and 33 healthy

subjects. TNF-a, IL-6 and IL-10, cICAM-1, tissue-type plasminogen activator

(t-PA), plasminogen activator inhibitor-1 (PAI-1) and D-dimer antigens were

measured in their blood by enzyme-linked immunosorbent assay (ELISA) test.

Patients were divided into sub-groups and the Stokes Index was use to describe

their disease activity. Group A had a minimal, mild disease activity (n=23,

Stoke Index=1-7). Group B had a moderate disease activity (n=12,Stoke

Index=8=11, and C showed severe disease activity (n=9, Stoke Index 12-17).

Patients with rheumatoid arthritis had significantly higher TNF-a, IL-6 and

IL-10 than healthy subjects. There was a tendency for TNF-a and IL-6 in contrast

to IL-10 to increase progressively with the increase of disease activity from

one subgroup to another, correlating significantly with Stoke Index. A positive

correlation was seen between TNF-a and IL-6 and PAI-1, and negatively with t-PA

and D-dimer.

There was also a positive correlation of IL-6 with fibrinogen and of both

cytokines with PAI-1/t-PA molar ratio found in all patients with rheumatoid

arthritis, whilst IL-10 showed a significant negative correlation only with

PAI-1.

A significant elevation was seen in patients with rheumatoid arthritis of serum

cICAM-1 by comparison with healthy subjects, which showed a tendency to increase

with increased disease activity from subgroup to subgroup. There was a positive

correlation between cICAM-1 and TNF-a and IL-6 and a negative one with IL-10 was

observed in rheumatoid arthritis.

" The Effect of Disease Activity Related Cytokines on the Fibrinolytic Potential

and cICAM-1 Expression in Rheumatoid Arthritis "

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