Prostaglandin E 2 (PGE 2 ) is a major mediator of inflammation and is present at high concentrations in the synovial fluid of rheumatoid arthritis (RA) patients. PGE 2 , acting through the EP4 receptor, has both pro-and anti-inflammatory roles in vivo. To shed light on this dual role of PGE 2 , we investigated its effects in whole blood and in primary human fibroblast-like synoviocytes (FLS). Gene expression analysis in human leukocytes, confirmed at the protein level, revealed an EP4-dependent inhibition of the expression of genes involved in the IFN-c-activation pathway, including IFN-c itself. This effect of the PGE 2 /EP4 axis on IFN-c is a reciprocal phenomenon since IFN-c blocks PGE 2 release and blocks EP receptor expression. The mutually antagonistic relationship between IFN-c and PGE 2 extends to downstream cytokine and chemokine release; PGE 2 counters the effects of IFN-c, on the release of IP-10, IL-8, TNF-a and IL-1b. To gain further insight into IFN-c-mediated cellular events in RA, we assessed the effects of IFN-c on gene expression in FLS. We observed an IFN-c-dependent up-regulation of macrophage-attracting chemokines, and down-regulation of metalloprotease expression. These results suggest the existence of a mutually antagonistic relationship between PGE 2 and IFN-c, which may represent a fundamental mechanism of immune control in diseases such as RA.