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Rheumatology 2003; 42: 681-688
© 2003 British Society for Rheumatology

Report

Fc{gamma} receptor expression levels on monocytes are elevated in rheumatoid arthritis patients with high erythrocyte sedimentation rate who do not use anti-rheumatic drugs

S. Wijngaarden1,, J. A. G. van Roon1,2, J. W. J. Bijlsma1, J. G. J. van de Winkel2 and F. P. J. G. Lafeber1

1 Rheumatology and Clinical Immunology and
2 Department of Immunology/Immunotherapy Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

Objectives. Levels of immunoglobulin G (IgG) Fc receptors (Fc{gamma}Rs) affect the activity and function of monocytes/macrophages when binding IgG-containing immune complexes. Hence, the expression level of Fc{gamma}Rs on monocytic cells may influence inflammation in patients with rheumatoid arthritis (RA). In this study the expression levels of Fc{gamma}RI, IIa and IIIa on peripheral blood monocytes of RA patients were compared with those of healthy controls and related to patient and disease characteristics and the use of disease-modifying anti-rheumatic drugs (DMARDs). In addition, Fc{gamma}R expression levels were determined on RA synovial fluid macrophages and compared with those in RA peripheral blood.

Methods. Mononuclear cells from peripheral blood and synovial fluid were isolated and Fc{gamma}R expression levels on CD14-positive cells were analysed by flow cytometry. The effects of patient and disease characteristics and the use of DMARDs were assessed.

Results. A high expression level of Fc{gamma}RIIa and high percentages of Fc{gamma}RIIIa-expressing monocytes were found in RA patients with a high erythrocyte sedimentation rate. DMARD-naive early RA patients had higher Fc{gamma}RIIa expression levels but a similar amount of Fc{gamma}RIIIa-positive monocytes compared with RA patients using DMARDs. In synovial fluid, Fc{gamma}RIIa expression levels were lower than in RA peripheral blood, whereas the percentage of Fc{gamma}RIIIa-positive monocytic cells was higher in synovial fluid than in peripheral blood.

Conclusions. These data point to the involvement of Fc{gamma}Rs, specifically Fc{gamma}RIIa and IIIa, in the immune response of RA and suggest that Fc{gamma}R expression levels are susceptible to modulation by DMARD therapy.

KEY WORDS: Fc{gamma} Receptor, Rheumatoid arthritis, Monocytes/macrophages, DMARDs.

Correspondence to: S. Wijngaarden, Rheumatology and Clinical Immunology (F02.127), University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. E-mail: s.wijngaarden{at}azu.nl


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