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Rheumatology Advance Access published online on February 28, 2003
Rheumatology, doi:10.1093/rheumatology/keg150
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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© 2003 British Society for Rheumatology

Paediatric Rheumatology

Synovial dendritic cells in juvenile idiopathic arthritis (JIA) express receptor activator of NF-{kappa}B (RANK)

H. Varsani 1, A. Patel 1, Y. van Kooyk 2, P. Woo 3, L. R. Wedderburn 1*

1 Rheumatology Unit, Institute of Child Health, University College London and Great Ormond Street Hospital for Children NHS Trust, London, UK
2 Department of Immunology, Free University Medical Centre, Amsterdam, The Netherlands
3 Department of Molecular Pathology and Immunology, University College London, London, UK

* Corresponding author. E-mail: l.wedderburn{at}ich.ucl.ac.uk.

Received 8 May 2002 ; accepted 30 September 2002

Abstract

Objectives. To analyse the expression of receptor activator of NF-{kappa}B (RANK) and RANK ligand (RANKL) in the joints of children with juvenile idiopathic arthritis (JIA), to characterize the phenotype of RANK+ cells and to test the hypothesis that some RANK+ cells are of the dendritic type.

Methods. Paired samples of peripheral blood mononuclear cells (PBMC) and synovial fluid mononuclear cells (SFMC) from children with oligoarticular (n=14) or polyarticular (n=4) JIA and PBMC from 10 control subjects were studied for expression of RANK, RANKL and dendritic cell-specific ICAM (intercellular adhesion molecule)-grabbing non-integrin (DC-SIGN) by the reverse transcriptase-polymerase chain reaction and three-colour flow cytometry. Expression of DC-SIGN and RANK was followed after 1 week of culture with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 4 (IL-4).

Results. mRNA for RANK was detected in both adherent cells and T cells from PBMC and SFMC of patients with JIA and in control PBMC, while mRNA for RANKL was detectable in the T-cell fraction from JIA patients but not in that from controls. By flow cytometry, a large number of RANK+ cells were detected in the joint; these cells had the phenotype HLA-DRhiCD86hi CD11c+ and expressed low levels of DC-SIGN.

Conclusions. There is increased expression of RANKL and RANK in the juvenile arthritic joint. RANK is expressed on a population of cells with features of dendritic cells. RANK/RANKL interactions may contribute to the survival of inflammatory cells within the joint, as well as to erosions and osteoporosis in juvenile arthritis.


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