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Enhanced Fcg Receptor I, aMß2 Integrin Receptor Expression by Monocytes and Neutrophils in Rheumatoid Arthritis: Interaction with Platelets
ANDREIA BUNESCU, PETER SEIDEMAN, RODICA LENKEI, KLAS LEVIN, and NILS EGBERG
ABSTRACT. Methods. Four-color flow cytometry analysis was performed for quantitative measurement of platelet (P-selectin, PAC-1) and leukocyte (CD11b, CD64) activation markers and estimation of percentage of leukocyte-platelet complexes in whole blood in 20 patients with RA before and after 6 weeks of therapy and in 20 controls. In addition, measures of soluble P-selectin (sP-selectin), ß-thromboglobulin, fibrinogen, prothrombin fragment 1+2, D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6), and TNF-a and tender and swollen joint counts were carried out. Results. Before therapy, PAC-1 binding, expression of CD11b and CD64 on monocytes and neutrophils, circulating levels of monocyte (CD11b+ or CD64+)-platelet complexes, monocyte-PAC-1+ platelet complexes, CRP, ESR, IL-6, TNF-a, fibrinogen, D-dimer and sP-selectin were significantly higher in RA patients compared to controls. The anti-TNF-a therapy significantly reduced levels of monocyte-PAC-1+ platelet complexes, sP-selectin, CRP, ESR, IL-6, TNF-a, fibrinogen, and D-dimer and tender and swollen joint counts. CD64 expression on monocytes was significantly decreased by MTX therapy. PAC-1 binding was not inhibited by MTX or anti-TNF-a. Conclusion. Increased platelet and leukocyte activation and increased formation of leukocyte-platelet complexes in patients with RA suggest a status of simultaneous activation of the immune and hemostatic systems. (J Rheumatol 2004;31:2347-55) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Department of Clinical Chemistry, Capio Diagnostik, St. Göran's Hospital; Reumacenter, Sabbatsberg Hospital; and the Departments of Medicine and Clinical Chemistry, Karolinska Institute, Stockholm, Sweden. Supported by Capio Diagnostik, Stockholm, Sweden. A. Bunescu, MD, Department of Clinical Chemistry, Capio Diagnostik, St. Göran's Hospital; P. Seideman, MD, PhD, Associate Professor, Reumacenter, Sabbatsberg Hospital, Department of Medicine, Karolinska Institute; R. Lenkei, MD, PhD, Flow Cytometry Laboratory, Capio Diagnostik, St. Göran's Hospital; K. Levin, MD, PhD, Department of Clinical Chemistry, Capio Diagnostik, St. Göran's Hospital; N. Egberg, MD, PhD, Associate Professor, Department of Clinical Chemistry, Karolinska Hospital. Address reprint requests to Dr. A. Bunescu, Department of Clinical Chemistry, Capio Diagnostik, St. Göran's Hospital, 11281 Stockholm, Sweden. E-mail: Andreia.Bunescu@capio.se Submitted July 10, 2003; revision accepted June 9, 2004. |