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*
Department of Clinical and Experimental Medicine, Section of Internal Medicine and Oncological Sciences, Center for the Study of Rheumatic Diseases,
Section of Hematology and Clinical Immunology, and
Institute of Internal and Vascular Medicine, University of Perugia, Perugia, Italy;
§
Department of Clinical and Experimental Medicine, Section of Internal Medicine, University of Verona, Verona, Italy; and
¶
Department of Rheumatology, Division of Medicine, Guy’s and St. Thomas’ School of Medicine, London, United Kingdom
High serum levels of soluble CD30 (sCD30) have been reported to
better predict the response to second line therapy in rheumatoid
arthritis (RA). It is believed that sCD30 is released by
CD30+ T cells present in the RA synovium. However, both the
mechanism of recruitment to the joint and the functional role of this T
cell subset in the pathogenesis of the disease remain unknown. This
study confirmed higher levels of sCD30 in the serum and synovial fluid
(SF) of RA patients compared with normal controls. However, analysis of
mRNA and cell surface CD30 expression showed that CD30+ T
cells are detectable in the SF, but not in the synovial membrane. In
contrast, T cells expressing the CD30 transcript, but not the surface
molecule, were found in the peripheral blood of both RA and normal
controls. CD30 surface expression was up-regulated by adhesion and
migration through endothelium in vitro and in a delayed-type
hypersensitivity model in vivo. Although the great majority of fresh or
cloned CD30+ T cells from SF produced both IFN-
and
IL-4, CD30 expression strictly correlated with IL-4 synthesis in
synovial T cell clones. In addition, CD30+ T cell clones
also produced high amounts of the anti-inflammatory cytokine IL-10.
On this basis, we would like to propose that synovial CD30+
cells may play a role in the control of the inflammatory response.
Serum sCD30 may reflect such cell activity and, therefore, explain the
previously demonstrated correlation between high sCD30 serum levels and
positive response to therapy.
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