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Rheumatology 2002; 41: 558-562
© 2002 British Society for Rheumatology


Original Papers

Macrophage migration inhibitory factor in rheumatoid arthritis: clinical correlations

E. F. Morand, M. Leech, H. Weedon1, C. Metz2, R. Bucala2 and M. D. Smith1

Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Melbourne,
1 Repatriation General Hospital, Daw Park, Adelaide, South Australia, Australia and
2 Picower Institute for Medical Research, Manhasset, NY, USA

Objective. Cytokines play an important role in the pathology of rheumatoid arthritis (RA). Macrophage migration inhibitory factor (MIF) is a cytokine with a broad spectrum of actions, including induction of monocyte tumour necrosis factor {alpha} (TNF-{alpha}). Evidence of the expression and proinflammatory activity of MIF has recently been demonstrated in RA synovium and in animal models of RA. We wished to assess the relationship between MIF expression in synovium and clinical disease.

Methods. Computer-assisted analysis of the cytokine content of arthroscopically obtained biopsies of RA synovium, using paired samples from eight patients with active and inactive/treated disease, was compared with documented clinical parameters.

Results. Synovial MIF immunostaining correlated strongly with disease activity as measured by CRP concentration. Reductions in clinical disease parameters, including CRP, tender and swollen joint counts, were accompanied by significant reductions in synovial MIF. Synovial TNF-{alpha}, transforming growth factor ß (TGF-ß) and interleukin (IL) 10 also showed a significant reduction in association with reduced disease activity, while IL-1ß and IL-1 receptor agonist did not.

Conclusion. The correlation of synovial MIF with disease activity corroborates existing evidence of the role of this cytokine in RA. The demonstration that only MIF and TNF-{alpha} show significant variation in synovial cytokine content with clinical remission suggests that MIF is an important member of the cytokine hierarchy in RA.

KEY WORDS: Macrophage, Fibroblast, Glucocorticoids, Synovial, Cytokine, Macrophage migration inhibitory factor, Rheumatoid arthritis.

Correspondence to: E. F. Morand, Centre for Inflammatory Diseases, Monash Medical Centre, Locked Bag No. 29, Clayton 3168, Melbourne, Australia.


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