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Histological analysis of synovium by treatment of etanercept for rheumatoid arthritis
Yutaka Suzuki1, Kazuhiko Inoue, Junji Chiba
1Department of Orthopaedic Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishiogu, Arakawa, Tokyo 116-8567, Japan.
Aims:
In order to investigate the histological change in effect attenuation cases of etanercept compared with methotrexate (MTX), we performed immunohistochemical examination by seven different molecules.
Methods:
We histologically assessed synovial tissue from five MTX-treated rheumatoid arthritis (RA) patients as control and six etanercept and MTX-treated RA patients after synovectomy by arthroscopy. The synovium of both groups were assessed by hematoxylin and eosin (HE) and we also analysed the expression of tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3), B-cell precursors and mature B-cell transmembrane protein, CD20, macrophage marker, CD68, bromodeoxyuridine (BrdU) and vascular endothelial growth factor (VEGF) by immunohistochemistry.
Results:
HE staining showed vascular and cell proliferations of the synovium of the RA patients who received etanercept compared with the control MTX group. TNF-alpha and IL-6 were expressed in both groups.MMP-3 and CD68 expressed less significantly in the etanercept group compared with the control (P < 0.05). CD20 strongly expressed in the etanercept group significantly (P < 0.05). BrdU expressed in the synovium in the etanercept group significantly (P < 0.05). VEGF was not found overall in both group.
Conclusion:
Based on the histological change of synovium, treatment by etanercept may be involved in vascular and cell proliferations with inhibition of the expression of CD68 and MMP-3 in synovium of RA patients. These findings indicate immunohistochemical change of synovium with etanercept is one of the mechanism of efficacy of etanercept.
Insights
Etanercept treatment in rheumatoid arthritis (RA) patients showed increased synovial vascularity and cell proliferation compared to methotrexate (MTX). This suggests etanercept
Area of Science:
- Rheumatology
- Immunohistochemistry
- Molecular Biology
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial hyperplasia.
- Etanercept and methotrexate (MTX) are commonly used RA treatments with different mechanisms of action.
- Understanding the histological changes induced by etanercept is crucial for elucidating its therapeutic effects.
Purpose of the Study:
- To investigate the histological differences in synovial tissue between RA patients treated with etanercept and those treated with MTX.
- To examine the expression of key molecules involved in inflammation and cell proliferation using immunohistochemistry.
Main Methods:
- Synovial tissue samples were obtained from RA patients treated with MTX (control) and those treated with etanercept plus MTX.
- Histological assessment included hematoxylin and eosin (HE) staining.
- Immunohistochemical analysis was performed for tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3), CD20, CD68, bromodeoxyuridine (BrdU), and vascular endothelial growth factor (VEGF).
Main Results:
- HE staining revealed increased vascular and cellular proliferation in the synovium of etanercept-treated RA patients compared to the MTX group.
- While TNF-alpha and IL-6 were expressed in both groups, MMP-3 and CD68 expression were significantly lower in the etanercept group.
- CD20 and BrdU expression were significantly higher in the synovium of etanercept-treated patients.
Conclusions:
- Etanercept treatment in RA patients is associated with synovial vascular and cellular proliferation.
- Etanercept may exert its effects by inhibiting CD68 and MMP-3 expression in the synovium.
- These histological and immunohistochemical changes provide insights into the mechanism of action of etanercept in RA.