Proinflammatory Cytokine Profiles of Patients with Elderly-Onset Rheumatoid Arthritis: A Comparison with Younger-Onset Disease

Abstract

Background: Little is known about the differences in the immunopathogenesis between elderly-onset rheumatoid arthritis (EORA) and younger-onset RA (YORA) and the factors responsible for their clinical characteristics. Objective: It was the aim of this study to investigate proinflammatory cytokines of EORA patients and compare them with those of YORA patients. Methods: Serum levels of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α and interferon (IFN)-γ were determined by cytometric bead array in 86 patients with active EORA, in 76 patients with active YORA and in 30 healthy controls. Disease activity of RA was assessed using the 28-joint disease activity score. Erosion scores were recorded using a modified version of the Sharp method. Levels of anti-cyclic citrullinated peptide antibodies were determined by ELISA, and levels of rheumatoid factor-IgM and C-reactive protein were measured by nephelometry. Results: A higher proportion of men and a higher frequency of acute onset with constitutional symptoms and comorbidities were observed in EORA compared with YORA patients. Increased levels of serum IL-1β, IL-6, TNF-α, IFN-γ and IL-8 were positively correlated with the 28-joint disease activity score, and elevated levels of IL-1β and TNF-α were positively correlated with erosion scores for both groups of RA patients. Significantly higher IL-6 levels and lower TNF-α levels were found in EORA compared with YORA patients. Higher levels of serum IL-6 were found in EORA patients with polymyalgia rheumatica-like symptoms than in those without and were also noted in male patients with EORA compared with female patients. Multivariate analysis showed that high levels of TNF-α were associated with the occurrence of constitutional symptoms, and high levels of IL-1β were associated with the presence of anti-cyclic citrullinated peptide antibodies in EORA patients. Conclusion: EORA patients appear to have differences in clinical characteristics and the patterns of proinflammatory cytokines when compared with YORA patients.

Phospholipase D1 Has a Pivotal Role in Interleukin-1β-Driven Chronic Autoimmune Arthritis through Regulation of NF-κB, Hypoxia-Inducible Factor 1α, and FoxO3a

“…Consistent with our findings (Fig. 1G), it has been reported that IL-1␤ is elevated in serum during RA, and this is correlated with higher disease activity (27). However, the signaling network of IL-1␤ in RAFLS is still poorly understood.…”

Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors

“…Although side effects can be detrimental to the physical and psychological functioning of all cancer survivors, older cancer survivors, due to additional age-related declines, may have more difficulty recovering from treatment-related side effects [3]. In addition, aging in the absence of a cancer history is associated with a decline in physical and psychological function, including sarcopenia, reduced strength, 5 reduced bone mineral density [6], lower functional capacity [7–8], arthralgias [9], depressive symptoms [10], anxiety [11], and cognitive difficulties [12]. Cancer and its treatments can exacerbate these common decrements in function and lead to additional impairments [3, 13–14].…”

Overview of biologic treatments in the elderly

“…In EORA, IL-6 levels are higher and TNF levels lower than in young subjects. Furthermore, in both age groups, a positive correlation has been found between IL-1, IL-6, TNF, IFN-␥ (Interferon), IL-8 and the DAS28 score, and between IL-1 and TNF and joint erosions [17]. In the elderly population, high levels of IL1ra and TNF were generally associated with an increased risk of death at one year [18].…”