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Serum cytokines and steroidal hormones in polymyalgia rheumatica and elderly-onset rheumatoid arthritis

M Cutolo1, C M Montecucco, L Cavagna

  • 1Department of Internal Medicine, Research Laboratory and Division of Rheumatology, University Hospital San Martino, Viale Benedetto XV no 6, 16132 Genova, Italy. mcutolo@unige.it

Annals of the Rheumatic Diseases
|April 29, 2006
PubMed
Abstract

Insights

Polymyalgia rheumatica (PMR) and elderly-onset rheumatoid arthritis (EORA) with PMR-like onset show distinct inflammatory profiles. These conditions exhibit a more intensive inflammatory reaction and better response to glucocorticoids compared to EORA.

Area of Science:

  • Rheumatology
  • Immunology
  • Endocrinology

Background:

  • Polymyalgia rheumatica (PMR) can complicate the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and EORA with a PMR-like onset (EORA/PMR).
  • Understanding the distinct inflammatory and hormonal profiles of these conditions is crucial for accurate diagnosis and effective treatment.

Purpose of the Study:

  • To investigate differences in serum inflammatory cytokine and steroidal hormone levels among patients with PMR, EORA, and EORA/PMR.
  • To assess changes in these biomarkers after 1 month of low-dose glucocorticoid treatment.

Main Methods:

  • Analysis of serum levels of Tumour Necrosis Factor alpha (TNFalpha), Interleukin 6 (IL6), IL1 receptor antagonist (IL1Ra), cortisol, dehydroepiandrosterone sulphate (DHEAS), and 17-hydroxy-progesterone (PRG).
  • Comparison between 14 PMR patients, 15 EORA patients, 14 EORA/PMR patients, and 15 healthy controls.
  • Evaluation of biomarkers at baseline and after 1 month of prednisone treatment (7.5-12.5 mg/day).

Main Results:

  • Elevated serum TNFalpha and IL6 levels were observed in all patient groups compared to controls.
  • Patients with PMR and EORA/PMR showed higher IL6 levels than EORA patients.
  • IL1Ra levels were higher in EORA patients than in controls and other patient groups. DHEAS was lower in EORA/PMR than EORA patients.
  • Glucocorticoid treatment led to decreased TNFalpha, IL6, cortisol, DHEAS, and PRG, and increased IL1Ra in specific patient groups.

Conclusions:

  • Distinct cytokine and steroidal hormone patterns differentiate PMR, EORA, and EORA/PMR.
  • PMR and EORA/PMR patients exhibit a more intense inflammatory response.
  • PMR and EORA/PMR patients appear to be more responsive to glucocorticoid therapy than EORA patients.

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