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*
Arthritis and Rheumatism Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, and
Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
Department of Clinical Pathology, Warren Grant Magnuson Clinical Center, and
Department of Radiology, National Naval Medical Center, Bethesda, MD 20892
Psoriatic arthritis (PsA) provides an ideal disease model in which
to investigate the bioactivities of potentially therapeutic cytokines
at multiple sites of tissue inflammation. We investigated the effects
of IL-10, an antiinflammatory cytokine, given s.c. for 28 days in a
double-blind, placebo-controlled study in PsA patients. Synovial/skin
biopsies, peripheral blood leukocytes, articular magnetic resonance
images, and clinical disease activity scores were obtained
sequentially. Modest, but significant clinical improvement in skin, but
not articular disease activity scores with only minor adverse effects
was observed. Type 1, but not type 2 T cell cytokine production in
vitro was suppressed in human rIL-10 compared with placebo recipients.
Similarly, monokine production in vitro was reduced, whereas serum
soluble TNFRII levels were elevated, indicating suppression of monocyte
function. Decreased T cell and macrophage infiltration in synovial
tissues was accompanied by reduced P-selectin expression. Moreover,
suppressed synovial enhancement on magnetic resonance imaging and
reduced 
v
3 integrin expression on von
Willebrand factor+ vessels were observed. Together these
data demonstrate that a short course of IL-10 modulates immune
responses in vivo via diverse effects on endothelial activation, and
leukocyte recruitment and effector function. Such biological changes
may result in clinically meaningful improvement in disease
activity.
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