Objective: To determine patterns of cytokine production and mRNA expression in synovium from patients with psoriatic arthritis (PsA) and to compare the profile of cytokine production in PsA explants with those derived from rheumatoid (RA) and osteoarthritic (OA) synovia and psoriatic skin.
Methods: Cytokine levels were measured in supernatants from synovial and dermal explant cultures at Day 10 by ELISA. Cytokine mRNA expression in PsA whole tissue was determined by multi-gene assay. Cytokine levels in explant supernatants were compared between PsA, RA and OA, and psoriatic skin. Synovial tissues were scored histologically by a pathologist blinded to the clinical diagnosis.
Results: PsA explants released elevated levels of interleukin (IL)-1beta, IL-2, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha, but not IL-4 or IL-5. A similar pattern of gene expression was detected in whole synovial tissue. These cytokine levels were greater in PsA than RA, despite higher histopathologic scores in RA explants. Production of IL-1beta, IFN-gamma, and IL-10 were strongly correlated. Levels of IFN-gamma, IL-1beta, and IL-10 were higher in psoriatic synovium than psoriatic dermal plaques.
Conclusion: The cytokine profile in PsA is characterized by the presence of Th1 cytokines and the monokines TNF-alpha and IL-1beta and very elevated levels of IL-10. The higher levels of these cytokines in PsA compared to RA suggest the presence of different underlying mechanisms.