Objective. Endothelin-1 (ET-1) is a potent vasoconstrictive peptide, but its precise mechanism of action in vivo has remained unknown.Methods. We measured ET-1 activity by radioimmunoassay, in both plasma and synovial fluid from patients with inflammatory arthritides.Results. ET-1-like immunoreactivity was found in synovial fluid, at levels severalfold higher than those in plasma. Reverse-phase high-performance liquid chromatography showed an elution profile corresponding to actual ET-1. A single class of high-atfinity binding sites for ET-1 in cultured synovial cells was also detected.
Conclusion. Taken together, these results indicate that ET-1 might contribute to the synovial proliferation seen in inflammatory arthritides, in an autocrine/paracrine manner.Endothelin-I (ET-I), a 21-amino acid polypeptide with 2 intramolecular disulfide bonds, induces potent, sustained vasoconstriction in vitro and longlasting elevation of blood pressure in vivo (1). It also stimulates in vitro proliferation of mesangial cells, fibroblasts, and vascular smooth muscle cells (2-4). Endothelin production in endothelial cells is augmented by thrombin, transforming growth factor P (TGFP), and interleukin-l (5,6), some of which are known to be up-regulated in rheumatoid arthritis (RA). We therefore hypothesized that endothelin might be produced locally in the joints of patients with inflammatory arthritides. In the present study, we investigated this hypothesis and examined the possible role of endothelin in joint destruction.
PATIENTS AND METHODSPatients. Twenty-three patients (18 women, 5 men; ages 39-82 years) who fulfilled the American College of Rheumatology (formerly, the American Rheumatism Association) criteria for RA (7), 11 patients (9 women, 2 men; ages 54-76 years) with osteoarthritis (OA) (5 of whom had inflammatory effusions in the knee), and 18 patients (all men; ages 34-58 years) with gout (4 of whom had acute knee arthritis with effusions) were entered into the study. Patients who were taking more than 5 mglday of prednisolone andlor 100 mglday of D-penicillamine were excluded from the study. RA patients were assigned to active or inactive