REDUCTION OF CHEMOKINE LEVELS AND LEUKOCYTE TRAFFIC TO JOINTS BY TUMOR NECROSIS FACTOR α BLOCKADE IN PATIENTS WITH RHEUMATOID ARTHRITIS

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Abstract

Objective.

To verify the hypothesis that in rheumatoid arthritis (RA), tumor necrosis factor α (TNFα) plays a critical role in regulating leukocyte trafficking and chemokine levels.

Methods.

Ten patients with longstanding RA received a single 10 mg/kg infusion of anti-TNFα monoclonal antibody (cA2). The articular localization of autologous granulocytes, separated in vitro and labeled with 111In, was studied by analysis of gamma-camera images both before and 2 weeks after treatment. At the same sequential time points, synovial biopsy samples were assessed for infiltrating CD3+ T cells, CD22+ B cells, and CD68+ macrophages. Synovial tissue expression of the chemokines interleukin-8 (IL-8), monocyte chemotactic protein 1 (MCP-1), macrophage inflammatory protein 1α (MIP-1α), MIP-1β, Groα, and RANTES was also determined. Serum IL-8 and MCP-1 concentrations were measured by enzyme-linked immunosorbent assay.

Results.

Anti-TNFα therapy in RA significantly reduced 111In-labeled granulocyte migration into affected joints. There was a simultaneous and significant reduction in the numbers of infiltrating synovial CD3+ T cells, CD22+ B cells, and CD68+ macrophages and in the expression of IL-8 and MCP-1, with a trend toward a reduction in serum concentrations of these chemokines.

Conclusion.

TNFα blockade reduces synovial expression of the chemokines IL-8 and MCP-1 and diminishes inflammatory cell migration into RA joints.

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