Ab1805

Absence of the association with CC chemokine receptor 5 polymorphism in polymyalgia rheumatica

C. Salvarani, L. Boiardi, J.M. Timms¹, T. Silvestri¹, A. Ranzi², P.L. Macchioni, L. Pulsatelli³, F.S. di Giovine¹

Servizio di Reumatologia, Azienda Ospedaliera Arcispedale S. Maria Nuova, Reggio Emilia; ¹Division of Molecular and Genetic Medicine, University of Sheffield, United Kingdom; ²Cattedra di Biometria e Statistica Medica, Istituto di Igiene, Università di Modena; ³Laboratorio di Immunologia e Genetica, Istituto Codivilla Putti, IOR Bologna, Italy.

ABSTRACT
Objective
Elevated RANTES serum levels are present in polymyalgia rheumatica (PMR) patients with active disease. Chemokines may contribute to the inflammatory PMR process through their binding to CC chemokine receptor 5 (CCR5). The aim of this study was to examine if the 32 base pair deletion allele in CCR5 (CCR5D32 allele) might be associated with PMR susceptibility and influence the disease outcome.

Methods
We enrolled 88 consecutive patients with PMR residing in the Reggio Emilia area (Italy) who had a follow-up duration of at least one year. As a control group we used 86 healthy blood donors from the same geographic area. The CCR5 genotype of all PMR patients and controls was studied by polymerase chain reaction amplification of the region which includes the 32 deletion (CCR5D32). RANTES serum levels were measured by commercial ELISA kits in CCR5D32 heterozygous and CCR5 homozygous PMR patients at diagnosis before starting corticosteroid therapy and again after 6 months of therapy, as well as in 28 healthy subjects over 50 years of age.

Results
Frequencies of the CCR5 and CCR5D32 alleles in patients and controls did not differ significantly. Homozygosity for CCR5D32 was not detected in PMR patients and was detected in only one of the controls. No significant differences were observed between the patients carrying the CCR5D32 allele and those homozygous for the normal CCR5 allele when we compared sex, presence of distal synovitis and systemic signs and/or symptoms, initial and cumulative prednisone dose, duration of therapy, ESR at diagnosis, frequency of relapse/recurrence and RANTES serum levels at diagnosis and after 6 months of corticosteroids.

Conclusion
These results indicate that the frequency of the 32 deletion of the CCR5 receptor was not significantly different between PMR patients and healthy controls, and this genotype does not appear to be associated with the susceptibility to or severity of PMR.

Key words
Polymyalgia rheumatica, CCR5 polymorphism, relapse/recurrence.

Please address reprint requests to: Dr. Carlo Salvarani, Servizio di Reumatologia, Arcispedale S.Maria Nuova, Viale Umberto I no. 50, 42100 Reggio Emilia, Italy.
E-mail: salvarani.carlo@asmn.re.it