Circulating cytokine levels in patients with rheumatoid arthritis: results of a double blind trial with sulphasalazine.

Abstract

Interleukin 1 (IL-1), IL-6, and tumour necrosis factor (TNF) a are pleiotropic cytokines produced predominantly by macrophages which have been implicated in the pathogenesis of rheumatoid arthritis (RA). Sulphasalazine has been shown to have disease modifying properties and to inhibit the production of cytokines in vitro. To evaluate the effect of sulphasalazine on cytokine production in vivo, serum cytokine levels were measured in a group of patients with RA entered into a randomised controlled trial. Serum levels of IL-la, IL-1,B, IL-6, and TNF a were measured at baseline and at two monthly intervals for six months in 17 patients receiving sulphasalazine and in 22 patients treated with placebo. The two groups of patients had a similar age and sex distribution, had had RA for less than a year, had no joint erosions, and had not been treated previously with any other disease modifying drugs.In the 39 patients studied IL-la was detected (>0.1 ng/ml) at baseline in 14 patients (median 0-24 ng/ml), IL-1,B in 25 patients (median 1-0 ng/ml), TNF a in 27 patients (median 1.2 ng/ml), and IL-6 in 33 patients (median 0.44 ng/ml). In the group treated with sulphasalazine there was a progressive and signficant decline in senrm IL-la, IL-1,B, and TNF a levels over the six month period (median levels at six months were <0-1, 0-12, and 0.44 ng/ml respectively). Interleukin 6 levels were significantly reduced only at the four month time point (median level of 0-23 ng/ml). These reductions were associated with improvements in clinical and laboratory measures of disease activity. In contrast patients receiving the placebo showed no changes in serum cytokine levels and no improvement in clinical and laboratory indices of disease activity. These results suggest that sulphalazne may exert its disease modifying effect partly by suppressing cytokine production in vivo. (Ann Rheum Dis 1992; 51: 946-950)

IL-23R rs11209026 polymorphism modulates IL-17A expression in patients with rheumatoid arthritis

“…Similar patterns of cytokine expression have been reported previously. 29 The concentrations of the cytokines measured in our study are consistent with those reported in other studies. 30,31 Although IL1b has been shown to correlate with RA disease severity, 32 our data suggest it is largely independent of the other cytokines measured, and tends to be present in large amounts or not at all.…”

Circulating soluble tumor necrosis factor receptors, interleukin‐2 receptors, tumor necrosis factor α, and interleukin‐6 levels in rheumatoid arthritis.

“…Decreases in IL-6 concentrations have been reported with intramuscular (43) and oral gold (44), while for sulfasalazine the results are contradictory (44,45). Neither MTX nor AZA altered TNFa concentrations in this study, but decreases have been observed during therapy with corticosteroids (36) and sulfasalazine (45).…”

Tumor Necrosis Factor-Alpha Level in Sera of South Indian Patients With Rheumatoid Arthritis: Correlation With Anticyclic Citrullinated Peptide Antibody Level

“…Their results showed that the median level of TNF-α was 1.2 ng/ml. Thus, the present study differs from earlier findings in the TNF-α level [6].…”

“…Development of sensitive immunoassays for cytokines has made it possible to show increased levels of some cytokines in the blood of patients with RA [6]. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine involved in the pathogenesis of RA, and antagonism of TNF may reduce the activity of the disease [7].…”