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document
The effects of treatment with interleukin-1 receptor antagonist on the inflamed synovial membrane in rheumatoid arthritis . OBJECTIVE To evaluate the effects of treatment with interleukin-1 receptor antagonist ( IL-1Ra ) on synovial tissue in rheumatoid arthritis ( RA ) . METHODS Twelve patients with RA entering a randomized clinical trial of human recombinant IL-1Ra underwent synovial biopsies before and after treatment . Cellular infiltration and adhesion molecule expression were evaluated after immunohistochemical staining . RESULTS There was a notable reduction in intimal layer macrophages and subintimal macrophages and lymphocytes after treatment with IL-1Ra at 150 mg/day ( n=3 ) . Increased cellular infiltration was observed in all patients receiving placebo ( n=3 ) ; variable changes were observed after IL-1Ra 30 mg/day ( n=6 ) . In a limited study of adhesion molecule expression , down-regulation of E-selectin and vascular cell adhesion molecule-1 was observed after treatment with IL-1Ra 150 mg/day , but not after IL-1Ra 30 mg/day or placebo . The apparent arrest of progressive joint damage seen in four patients after treatment with IL-1Ra was associated with reduced intimal layer macrophage accumulation in all patients . CONCLUSION Treatment of RA with IL-1Ra resulted in reduced mononuclear cell infiltration of synovial membrane , which may represent the in vivo inhibition of biologically relevant IL-1ss-mediated pathogenic effects .
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Intervention_Pharmacological
interleukin-1 receptor antagonist
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Intervention_Pharmacological
interleukin-1 receptor antagonist ( IL-1Ra )
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Intervention_Pharmacological
human recombinant IL-1Ra
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Intervention_Surgical
synovial biopsies
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Intervention_Pharmacological
IL-1Ra
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Intervention_Control
placebo
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Intervention_Pharmacological
IL-1Ra
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Intervention_Pharmacological
IL-1Ra
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Intervention_Pharmacological
IL-1Ra
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Intervention_Control
placebo
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Intervention_Pharmacological
IL-1Ra
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Intervention_Pharmacological
IL-1Ra
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Outcome_Physical
Cellular infiltration and adhesion molecule expression
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Outcome_Physical
reduction in intimal layer macrophages and subintimal macrophages and lymphocytes
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Outcome_Physical
cellular infiltration
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Outcome_Physical
down-regulation of E-selectin and vascular cell adhesion molecule-1
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Outcome_Physical
arrest of progressive joint damage
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Participant_Condition
rheumatoid arthritis
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Participant_Sample-size
Twelve patients