Elevated serum levels of TNF-α and IL-17 in psoriatic and rheumatoid arthritis
Vol. 31 No. 1 (2023), Original Articles
Vol. 31 No. 1 (2023)

Elevated serum levels of TNF-α and IL-17 in psoriatic and rheumatoid arthritis

Original Articles
https://doi.org/10.35465/31.1.2023.pp23-36
Published May 25, 2023
Alexander Krasimirov Angelov
UMBAL "St Ivan RIlski"
G. Vasilev
A. Yordanova
E. Ivanova-Todorova
D. Kyurkchiev
Mariana Ivanova
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Keywords

psoriatic arthritis, rheumatoid arthritis, TNF-α, IL-17

How to Cite

Angelov, A., Vasilev, G., Yordanova, A., Ivanova-Todorova, E., Kyurkchiev, D., & Ivanova, M. (2023). Elevated serum levels of TNF-α and IL-17 in psoriatic and rheumatoid arthritis. Rheumatology (Bulgaria), 31(1), 23-36. https://doi.org/10.35465/31.1.2023.pp23-36
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Abstract

Psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are chronic inflammatory immune-mediated rheumatic diseases, in which cytokine dysregulation is key for pathogenesis. In terms of the specific processes involved in predominantly enthesopathic inflammation and predominantly synovial inflammation, PsA and RA are distinct disease entities. The aim of the present study was to investigate the serum cytokine expression profiles of TNF-α and IL-17 in the two inflammatory arthropathies, discussing their role in the context of disease activity assessed by means of DAS28-CRP, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The study included 32 patients with PsA, 30 with RA and 20 healthy subjects. In patients with RA and PsA, higher serum levels of both cytokines were measured compared to healthy controls, with the difference being significant, except for TNF-α for patients with PsA, whose concentration was numerically but not significantly higher compared to healthy individuals. We also recorded a significant increase in circulating TNF-α in RA versus PsA, with no difference for IL-17 in the two inflammatory joint diseases. The two studied cytokines did not show a significant difference in serum concentrations according to the state of the disease activity (DAS28- CRP < 3.2 vs. DAS28- CRP ≥ 3.2) in both PsA and RA, as well as association with clinical and laboratory parameters of activity from correlation analyses, supporting the claim that they are not useful markers for its assessment. In conclusion, both cytokines are clearly abundant in the circulation in conditions of both inflammatory arthropathies. The TNF-α and IL-17 pathways are important links and an active participant in these types of rheumatic inflammation.

https://doi.org/10.35465/31.1.2023.pp23-36
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References

  1. Chung Kian Fan. Chapter 27 - Cytokines. In: Asthma and COPD (Second Edition), 2009;327-341.
  2. Boissier M-C. Cell and cytokine imbalances in rheumatoid synovitis. Joint Bone Spine 2011;78(3):230-234.
  3. O'Shea JJ, Ma A, Lipsky P. Cytokines and autoimmunity. Nat Rev Immunol 2002;2(1):37-45.
  4. Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. The Lancet 2018;391(10136):2273-2284.
  5. McInnes I, Schett G. Cytokines in the pathogenesis of rheumatoid arthritis. Nat Rev Immunol 2007;7:429-442.
  6. Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med 2017;376:2095-2096.
  7. Araujo EG, Schett G. Enthesitis in psoriatic arthritis (Part 1): pathophysiology. Rheumatology (Oxford) 2020;59(Suppl 1):10-14.
  8. Smolen JS, Aleataha D, McInnes IB. Rheumatoid Arthritis. The Lancet 2016;388(10055):2023-2038.
  9. Miossec P, Korn T, Kuchroo VK. Interleukin-17 and type 17 helper T cells. N Engl J Med 2009;361(9):888-898.
  10. Korn T, Bettelli E, Oukka M, Kuchroo VK. IL-17 and Th17 Cells. Annu Rev Immunol 2009;27:485-517.
  11. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006;54(8):2665-2673.
  12. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010;62(9):2569-81.
  13. McGonagle D, Conaghan P, Emery P. Psoriatic arthritis—a unified concept 20 years on. Arthritis Rheum 1999;42:1080-6.
  14. McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet 1998;352(9134):1137-40.
  15. Appel H, Braun J. Synovitis in Spondyloarthritides. The Open Rheumatology Journal, 2011, 5, (Suppl 1:M5) 123-126.
  16. Hitchon CA, El-Gabalawy HS. The synovium in rheumatoid arthritis. Open Rheumatol J. 2011;5:107-14.
  17. Иванова М., Р. Стоилов, Р. Ганчева, Сп. Станилова и И. Манолова. Серумно ниво на TNF-α при ревматоиден артрит във връзка с болестната активност и провежданата терапия. Ревматология 2013;21(4):31-37.
  18. Partsch G, Steiner G, Leeb BF, Dunky A, Bröll H, Smolen JS. Highly increased levels of tumor necrosis factor-α and other proinflammatory cytokines in psoriatic arthritis synovial fluid. J Rheumatol 1997;24:518–23.
  19. Ritchlin C, Haas-Smith SA, Hicks D, Cappuccio J, Osterland CK, Looney RJ. Patterns of cytokine production in psoriatic synovium. J Rheumatol 1998;25:1544–52.
  20. Wei ST, Sun YH, Zong SH, Xiang YB. Serum Levels of IL-6 and TNF-α May Correlate with Activity and Severity of Rheumatoid Arthritis. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2015 Dec;21:4030-4038.
  21. Jang DI, Lee AH, Shin HY, Song HR, Park JH, Kang TB, Lee SR, Yang SH. The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics. Int J Mol Sci 2021;22(5):2719.
  22. Haworth C, Brennan FM, Chantry D, Turner M, Maini RN, Feldmann M. Expression of granulocyte‐macrophage colony‐stimulating factor in rheumatoid arthritis: regulation by tumor necrosis factor‐α. Eur J Immunol 1991;21:2575-2579.
  23. Butler DM, Maini RN, Feldmann M, Brennan FM. Modulation of proinflammatory cytokine release in rheumatoid synovial membrane cell cultures. Comparison of monoclonal anti TNF-alpha antibody with the interleukin-1 receptor antagonist. Eur Cytokine Netw 1995;6(4):225-230.
  24. Feldmann M, Brennan FM, Maini RN. Rheumatoid arthritis. Cell 1996; 85: 307-310.
  25. Hess A, Axmann R, Rech J, Finzel S, Heindl C, Kreitz S, Sergeeva M, Saake M, Garcia M, Kollias G, Straub RH. Blockade of TNF-α rapidly inhibits pain responses in the central nervous system. Proc Natl Acad Sci USA 2011; 108: 3731-3736.
  26. Danning CL, Illei GG, Hitchon C, Greer MR, Boumpas DT, McInnes IB. Macrophage-derived cytokine and nuclear factor kB p65 expression in synovial membrane and skin of patients with psoriatic arthritis. Arthritis Rheum 2000;43:1244–56.
  27. Kolls JK, Linden A. Interleukin-17 family members and inflammation. Immunity 2004;21:467-476.
  28. Nakae S, Saijo S, Horai R, Sudo K, Mori S, Iwakura Y. IL-17 production from activated T cells is required for the spontaneous development of destructive arthritis in mice deficient in IL-1 receptor antagonist. Proc Natl Acad Sci USA 2003;100:5986-5990.
  29. Kotake S, Udagawa N, Takahashi N, et al. IL-17 in synovial fluids from patients with rheumatoid arthritis is a potent stimulator of osteoclastogenesis. J Clin Invest 1999;103:1345-1352.
  30. Honorati MC, Meliconi R, Pulsatelli L, et al. High in vivo expression of interleukin-17 receptor in synovial endothelial cells and chondrocytes from arthritis patients. Rheumatology (Oxford) 2001;40:522-527.
  31. Kunwar S, Dahal K, Sharma S. Anti-IL-17 therapy in treatment of rheumatoid arthritis: a systematic literature review and meta-analysis of randomized controlled trials. Rheumatol Int 2016;36(8):1065-75.
  32. Yamada H, Nakashima Y, Okazaki K, et al. Th1 but not Th17 cells predominate in the joints of patients with rheumatoid arthritis. Ann Rheum Dis 2008;67:1299-1304.
  33. Benham H, Norris P, Goodall J, Wechalekar MD, FitzGerald O, Szentpetery A, Smith M, Thomas R, Gaston H. Th17 and Th22 cells in psoriatic arthritis and psoriasis. Arthritis Res Ther 2013;15:R136.
  34. Mease PJ, McInnes IB, Kirkham B, et al. Secukinumab inhibition of interleukin-17A in patients with psoriatic arthritis. N Engl J Med Overseas Ed 2015;373:1329–39.
  35. Shen F, Gaffen S. Structure–function relationships in the IL-17 receptor: implications for signal transduction and therapy. Cytokine 2008;41:92-104.
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