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Elevated levels of insulin-like growth factor (IGF) binding protein-3 in rheumatoid arthritis synovial fluid inhibit stimulation by IGF-I of articular chondrocyte proteoglycan synthesis
Authors:J. Neidel  W. F. Blum  H.-J. Schaeffer  M. Schulze  E. Schönau  J. Lindschau  J. Föll
Affiliation:(1) Department of Orthopaedics, The Centre for Rheumatology, Bad Bramstedt, Germany University of Hamburg, Hamburg, Germany, DE;(2) Lilly Germany GmbH, Bad Homburg, Germany University Children's Hospital Giessen, Germany, DE;(3) Laboratories for Endocrinology, Clinic for Obstetrics and Gynaecology, University of Cologne, Cologne, Germany, DE;(4) Clinic for Orthopaedics, Hospital of the Hannover Medical School, Hannover, Germany, DE;(5) Clinic for Paediatrics, University of Cologne, Cologne, Germany, DE;(6) Department of Orthopaedics, The Centre for Rheumatology, Bad Bramstedt, Germany, DE;(7) University Children's Hospital, Tübingen, Germany, DE;(8) Department of Orthopaedics, The Centre for Rheumatology, Oskar-Alexander-Strasse 26, D-24576 Bad Bramstedt, Germany Tel. +49-4192-902415; Fax: +49-4192-902388, DE
Abstract:The objective of this study was to quantify insulin-like growth factor (IGF) binding proteins (IGFBPs) in the synovial fluid (SF) and plasma of patients with rheumatic diseases and to study the role of these proteins in the regulation of cartilage proteoglycan (PG) synthesis. Immunological determination of IGFBP-2, IGFBP-3, IGF-I, IGF-II, interleukin-1β (IL-1β) and tumour necrosis fac-tor α (TNFα) was undertaken in the SF and plasma of 115 patients with rheumatoid arthritis (RA; n = 53), osteoarthritis (OA; n = 44) and other rheumatic disorders. We also determined the effects of SF on bovine cartilage PG synthesis in culture. IGFBP-2 and IGFBP-3 were elevated in the plasma (by 38% and 28%, respectively) and SF (by 56% and 59%, respectively) of patients with RA compared to age- and sex-matched OA controls (determined by RIA and confirmed by Western ligand blot). IGF-I and IGF-II did not differ significantly between the two groups. OA SF, and, to a lesser extent, RA SF stimulated cartilage PG synthesis in culture, and more than 60% of this activity was neutralised by a specific monoclonal anti-IGF-I antibody. Human IGFBP-3 dose-dependently inhibited the stimulation of cartilage PG synthesis effected by SF or human IGF-I. In RA patients, the SF concentration of IGFBP-3 was positively correlated with SF levels of IL-1β and TNFα, with the serum level of C-reactive protein and with the erythrocyte sedimentation rate. We concluded that IGF-I is, under the conditions studied, the most important anabolic factor in human SF with respect to articular cartilage PG synthesis. The bioactivity of IGF-I in joints is modulated by IGFBP-3, which is elevated in RA SF compared to OA SF. Elevated IGFBP-3 in RA SF may reduce the availability of IGF-I to articular chondrocytes, thus interfering with cartilage PG synthesis in RA. Received: 30 November 1996 / Accepted: 19 February 1997
Keywords:Insulin-like growth factors  Insulin-like growth factor binding proteins  Rheumatoid arthritis  Articular cartilage  Proteoglycans
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