Soluble CD21 in sera and synovial fluid of arthritic patients

Soluble CD21 (sCD21) is the ectodomain of the CD21 glycoprotein released by shedding from the cellular membrane. The ectodomain of CD21 is capable of binding complement fragments, Epstein-Barr virus (EBV) and CD23. Functionally sCD21 can activate monocytes and abrogate B-cell/follicular dendritic cell interaction, thereby inhibiting antibody production by antigen primed B cells. Levels of sCD21 vary in several clinical conditions. Here we analyzed sCD21 in synovial fluids and sera in arthritic patients. sCD21 concentrations were consistently lower in synovial fluids compared to paired sera samples from the same patients. In contrast to healthy donors, sCD21 levels are significantly reduced in rheumatoid arthritis patients sera. Potential causes and consequences of the data are discussed.     

Cerebrospinal fluid and serum neopterin levels in patients with Lyme neuroborreliosis

Summary Elevated (>3.0 nmol/l) cerebrospinal fluid neopterin concentrations were observed in 20 of 21 patients with Lyme neuroborreliosis compared with three of 11 control patients with headache, back pain or psychoneurotic disorders. Neopterin concentrations were correlated to mononuclear cell counts and protein concentrations in the cerebrospinal fluid (CSF). Following antibiotic treatment, CSF neopterin levels decreased. Serum neopterin levels were not significantly raised in patients with neuroborreliosis when compared to control subjects. Neopterin levels as well as cell count and protein concentration in the CSF are valuable inflammation markers of disease activity in Lyme neuroborreliosis.

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Neopterin-Liquor- und Serumspiegel bei Patienten mit Lyme Neuroborreliose

Zusammenfassung Bei 20 von 21 Patienten mit Lyme Neuroborreliose fanden sich erhöhte Spiegel (>3,0 nMol/l) von Neopterin im Liquor; bei Patienten mit Kopfschmerzen, Rückenschmerzen oder neurotischen Störungen war dies nur in drei von elf Fällen nachzuweisen. Es bestand eine Korrelation zwischen dem Liquorgehalt an mononukleären Zellen und Eiweiß. Nach Antibiotikatherapie gingen die Neopterinspiegel zurück. Im Vergleich zu den Kontrollpersonen war bei den Patienten mit Neuroborreliose keine signifikante Erhöhung der Neopterinspiegel im Serum festzustellen. Die Neopterinspiegel im Liquor sind neben den Zellzahlen und der Eiweißkonzentration wertvolle unspezifische Entzündungsmarker und Parameter für die Krankheitsaktivität bei Neuroborreliose.

     

Interferon in synovial fluid and serum of patients with rheumatic disease

Interferon (IFN) was sought in simultaneously obtained samples of synovial fluid (SF) and serum from patients with a variety of rheumatological diseases. IFN was identified in 11 of 84 samples of SF and 10 of 84 specimens of serum. IFN positive specimens were contributed by patients with rheumatoid arthritis (RA), systemic lupus erythematosus, seronegative spondyloarthropathies, pseudogout, coccidioidomycosis and unclassified arthritis. Significantly, IFN was frequently found either in SF or in serum but generally not in both of the simultaneously obtained fluids. The highest titers of IFN found in SF were from patients with RA.     

Adenohypophyseal hormone levels in the cerebrospinal fluid of patients with pituitary disease

Measurement of adenohypophyseal hormones in the cerebrospinal fluid (CSF) was recently proposed as an useful procedure to differentiate pituitary intra and extrasellar tumors. So far, data reported are conflicting. We measured the concentrations of GH, TSH, LH and PRL in CSF and plasma in 30 controls and in 37 patients with various pituitary diseases (18 intrasellar adenomas, 14 extrasellar adenomas and 5 empty sella syndromes). The concentrations of examined hormones in CSF were very low or undetectable in all control subjects. In most patients with pituitary tumors, adenohypophyseal hormones were found to be present in CSF, in great amounts. No significant differences were found between intra and extrasellar tumors. In agreement with recently reported data, no significant correlation was found between GH, TSH, FSH and LH levels in CSF and plasma, while a significant correlation (p less than 0.01) was obtained between CSF and plasma levels of PRL, either in all patients or in those with extrasellar tumors only. All patients bearing an empty sella had PRL detectable in CSF: in 2 cases PRL levels were very high. In conclusion our data do not confirm that measurement of adenohypophyseal hormones in CSF represents an useful screening to differentiate tumors with extrasellar extension. PRL data deserve interest in order to gain understanding of the hormone dynamics between CSF and vascular compartments.     

Variation in polyol levels in cerebrospinal fluid and serum in diabetic patients

Cerebrospinal fluid (CSF) or CSF and plasma levels of sorbitol, 1,5-anhydroglucitol and myoinositol of diabetic and non-diabetic patients with normal kidney function and of diabetic and non-diabetic patients with impaired kidney function were measured by gas-liquid chromatography. The CSF sorbitol level correlated with the plasma glucose level (p less than or equal to 0.05) in diabetic patients with normal kidney function, having received insulin for less than 12 months. The correlation between CSF sorbitol and plasma glucose levels in patients not dependent on insulin was not significant. Sorbitol was not detected in the plasma. The highest sorbitol levels in CSF were seen in insulin-dependent diabetic patients with impaired kidney function. No rise was seen in non-diabetic uremia. 1,5-anhydroglucitol, normally present in plasma, was absent from CSF and plasma in diabetic patients receiving insulin. In non-diabetic uremic patients, 1,5-anhydroglucitol levels in CSF and plasma were lower than in healthy subjects, but htere was no correlation with plasma glucose levels. The myoinositol level was higher in CSF than in the plasma of both non-diabetic and diabetic patients with normal kidney function. Both plasma and CSF levels were significantly (p less than 0.001) elevated in diabetic as well as in non-diabetic uremic patients, the plasma myoinositol increasing relatively more than the CSF levels. The elevation of plasma myoinositol correlated with the elevation of plasma creatinine and thus also with the impairment of kidney function. Plasma and CSF myoinositol levels were not influenced by the plasma glucose level.     

Elevated soluble CD4 levels in the cerebrospinal fluid in patients with adult T-cell leukemia

Levels of the soluble form of the leukocyte surface antigen CD4 (sCD4) were measured by enzyme linked immunosorbent assay (ELISA) in the cerebrospinal fluid (CSF) of patients with adult T-cell leukemia (ATL) and other malignant and non-malignant diseases. All patients with ATL and meningeal infiltration had markedly elevated levels of sCD4 in the CSF (53.7 ± 34.9 U/ml). ATL patients without CSF pleocytosis often had elevated levels of sCD4 (15.1 ± 9.2 U/ml). Non-ATL patients with CSF pleocytosis had elevated levels of sCD4 (23.3 ± 12.2 U/ml) and those without CSF pleocytosis also showed elevation of sCD4 levels (16.8 ± 9.3 U/ml). However, the mean levels of sCD4 in CSF from these patients were significantly lower than ATL patients with meningeal infiltration. Soluble CD4 in the CSF from healthy volunteers were below the detectable limit. We conclude that meningeal infiltration of CD4(+) ATL cells is strongly associated with elevated sCD4 levels in CSF, and some part of sCD4 in CSF may be originated from the native cells in the CNS as a response of inflammatory stimulations. Therefore, measurement of sCD4 may be useful in the diagnosis of meningeal infiltration and/or meningeal irritation in patients with ATL. © 1994 Wiley-Liss, Inc.     

Significant elevation of serum soluble CD14 levels in patients with brucellosis

Activation of macrophages represents one of the initial events in innate immunity to intracellular infections. CD14 is expressed principally by cells of monocyte/macrophage lineage and plays a pivotal role in innate recognition of bacterial cell wall components, particularly lipopolysaccharides. We measured serum concentrations of soluble CD14 (sCD14) in serum samples obtained from 37 patients with brucellosis and 36 healthy controls. Serum levels of sCD14 were significantly increased in patients with brucellosis compared with those in healthy controls (P < 0.001). Re-analysis of serum samples after treatment in 25 patients demonstrated that treatment did not result in any significant decline in sCD14 levels. Despite a limited study population, these findings may implicate CD14 signaling as an important component of the initial anti-brucellar host response and suggest that activation of mononuclear phagocytic system is sustained even following effective treatment.     

Increased cerebrospinal fluid levels of 3,3',5'-triiodothyronine in patients with Alzheimer's disease

Cerebrospinal fluid (CSF) levels of rT(3) were evaluated in 21 euthyroid patients with overt Alzheimer's disease (AD) and 18 matched healthy controls. The assessment also included transthyretin and total T(3) and T(4) CSF concentrations. Despite normal circulating thyroid hormone levels, AD subjects showed significantly increased rT(3) levels and an increased rT(3) to T(4) ratio in the face of unchanged CSF total T(4) and transthyretin levels. These results suggest an abnormal intracerebral thyroid hormone metabolism and possibly the occurrence of brain hypothyroidism, either as a secondary consequence of the ongoing process or as a cofactor in the progression of the disease.     

Gastrointestinal peptides in serum and synovial fluid from patients with inflammatory joint disease.

The concentrations of immunoreactive vasoactive intestinal polypeptide (ir-VIP), immunoreactive pancreatic polypeptide (ir-PP), ir-somatostatin, and ir-secretin were measured in serum and synovial fluid from patients suffering from various inflammatory joint diseases. One group of patients were not taking any medication, while another group received anti-inflammatory treatment at the time of sampling. High levels of ir-VIP in the synovial fluid were observed in the untreated group of patients, and the concentration of ir-VIP in the synovial fluid was significantly higher than in parallel serum samples. On the other hand, no significant differences in the concentrations of the other peptides were observed either between serum and synovial fluid or between the two groups of patients. It is suggested that VIP is released locally at the inflammatory site and that VIP may be of significance in inflammatory disorders.     

Neutrophil chemotactic factors in synovial fluids of patients with Lyme disease

We examined synovial fluid samples from 14 patients with Lyme arthritis for the presence of neutrophil chemotactic factors. Thirteen of the synovial fluids stimulated chemotaxis of normal human neutrophils. The chemotactic activity was heat-sensitive and was not inhibited by antibody to C5a or antibody to interleukin-8, or by a competitive inhibitor of the chemotactic peptide f-Met-Leu-Phe. A culture supernatant of Borrelia burgdorferi also contained neutrophil chemoattractants. Chromatography demonstrated that the chemoattractants in the synovial fluid samples were different from those in the B burgdorferi culture supernatant. One of the major chemotactic factors in Lyme disease synovial fluid had a calculated molecular weight of 13,900. We conclude that a novel, host-derived chemoattractant is present in the synovial fluid of patients with Lyme disease.     

Vascular endothelial growth factor levels in the serum and synovial fluid of patients with rheumatoid arthritis.

OBJECTIVE: To determine the vascular endothelial growth factor (VEGF) concentrations in serum and synovial fluid (SF) from patients with rheumatoid arthritis (RA) and to search for relationships between VEGF levels and clinical and laboratory variables. METHODS: We measured VEGF levels using an enzyme-linked immunosorbent assay. Serum samples were obtained from 99 RA patients, 49 osteoarthritis (OA) patients, and 80 normal controls. Paired samples of serum and SF were collected from 32 patients with RA and 15 with OA. RESULTS: The mean serum VEGF concentration was 590.1 pg/ml for RA patients, 286.7 pg/ml for OA patients, and 265.8 pg/ml in controls. The serum VEGF concentration was significantly higher in the RA patients than in the OA patients or the controls (both p < 0.001). Furthermore, the VEGF levels in SF from RA patients were significantly higher than in SF from OA patients (p = 0.017). However, there was no correlation between VEGF levels in serum and SF from the same RA patients. The serum VEGF concentration was correlated with the ESR, serum CRP concentration, serum rheumatoid factor, number of tender and swollen joints, Modified Health Assessment Questionnaire, and patient and physician global assessments of disease activity in RA patients. CONCLUSION: These results suggest that VEGF level is related to RA disease activity, suggesting that VEGF may play some role in the pathogenesis of RA.     

类风湿关节炎患者血清滑液和滑膜组织白细胞介素-18的水平及意义

目的 研究类风湿关节炎（RA）患者血清、滑液中白细胞介素－18（IL－18）蛋白及滑膜组织IL－18mRNA表达水平，探讨其在RA致病中的作用。方法 应用双抗夹心酶免疫吸附（ELISA）法和细胞生物法分别测定RA患者血清、滑液中IL－28蛋白水平和生物活性，同时还检测NO、前列腺素E2的含量；有用半定量RT－PCR法检测膜组织IL－18m RNAG表达水平。以骨关节炎（OA）病人及因外伤截肢的正常人作对照。结果 RA患者血清、滑液中IL－18蛋白水平和生物活性均显著高于对照组，滑液中量及活化性比血清高；RA滑膜组织IL－18mRNA表达水平也明显高于对照组。结论 过度表达的IL－18参与了RA的致病过程,；选择性地抑制IL－18生物活性，将是RA治疗的新途径。     

阿尔茨海默病患者血清和脑脊液中白细胞介素-2及白细胞介素-2受体水平的研究

目的　探讨阿尔茨海默病 (AD)的病因及发病机制。方法　采用双抗体夹心酶联免疫吸附试验分别对AD患者血清和脑脊液中白细胞介素 2 (IL 2 )及白细胞介素 2受体 (sIL 2R)水平进行检测。结果　 (1)AD组脑脊液 (CSF)中sIL 2R阳性率明显高于脑血管性痴呆 (VD)组及对照组 (P <0 .0 5 ) ;(2 )AD组血清和CSF中IL 2和sIL 2R含量明显高于VD组和正常对照组 (P <0 .0 5 ,P <0 .0 1) ;(3)AD组IL 2与sIL 2R在血清或CSF中含量均呈正相关 ,与简易智力状态检查量表得分呈负相关。结论　AD组患者CSF中IL 2和sIL 2R可来源于外周免疫系统 ,还可能来源于中枢神经系统的自身合成。检测AD患者CSF中IL 2和sIL 2R水平可反映AD的病理改变程度     

Soluble HLA class I antigens in serum and synovial fluid from patients with rheumatoid arthritis and other arthropathies.

OBJECTIVES: To investigate the presence of soluble HLA class I (s-HLA) antigens in serum and synovial fluid (SF) from a large cohort of rheumatic patients. METHODS: We studied clinical and analytical data and serum samples from 300 patients [122 patients with rheumatoid arthritis (RA), 38 with osteoarthritis or osteoporosis, 29 with seronegative spondyloarthropathies, 45 patients with other rheumatic diseases] and 66 healthy controls. In addition, we studied 25 paired samples of serum and SF from these groups of subjects. In RA patients, we examined whether the levels of s-HLA in serum and SF were related to the activity of the disease. RESULTS: The mean concentrations of s-HLA molecules in serum were slightly higher in RA patients (1.2 microg/ml) than in the other four groups (1.08, 1.01, 1.09 and 0.94 microg/ml respectively). We found no correlation between serum s-HLA levels and any variable of inflammatory disease activity in RA patients. s-HLA molecules were found in SF and at levels that correlated with those found in serum (P=0.04; r=0.4). Furthermore, s-HLA levels were higher in SF from patients with RA (1.3 microg/ml) or crystal-induced arthritis (0.98 microg/ml) than in SF from those with osteoarthritis (0.38 microg/ml) (P<0.05 and P<0.005 respectively), and these levels were correlated inversely and significantly with the score on the visual analogue scale of pain (P=0.02), the number of painful joints (P=0.05) and the level of C-reactive protein (P=0.03) in RA patients. CONCLUSIONS: This is the first report to demonstrate the presence of s-HLA molecules in SF at levels that correlate with serum levels. The mean levels of s-HLA molecules were significantly higher in SF from patients with RA and crystal-induced arthritis than in SF from cases of osteoarthritis, and correlated inversely with certain variables of disease activity in RA patients.