ab17_4

Relationship between serum rantes levels and radiological progression in rheumatoid arthritis patients treated with methotrexate

L. Boiardi¹, P. Macchioni¹, R. Meliconi²,⁴, L. Pulsatelli⁴, A. Facchini³,⁴, C. Salvarani¹

¹Servizio di Reumatologia, Azienda Ospedaliera S. Maria Nuova, Reggio Emilia; ²Dipartimento di Medicina Interna, Cardioangiologia, Epatologia and ³Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna; ⁴Laboratorio di Immunologia e Genetica, Istituto di Ricerca Codivilla Putti, IOR, Bologna, Italy.

ABSTRACT
Objective
The aim of this study was to evaluate the relationship between serum chemokines and the clinical and radiological response to a one-year course of methotrexate (MTX) in patients suffering from rheumatoid arthritis (RA).

Methods
Twenty out-patients suffering from active RA entered a one-year open prospective study on the effects of low dose MTX therapy. Plain radiographs of the hands and feet were taken at study entry and at the end of the follow-up, and were compared for the number of eroded joints. Serum levels of both C-X-C and C-C chemokines were obtained before the initation of MTX and after 6 and 12 months of treatment.

Results
The levels of serum RANTES before treatment were significantly higher in RA patients than in the controls and returned to normal levels after one year of treatment. Serum levels of the other chemokines were either in the normal range or undetectable. Twelve patients (60%) did not show any new eroded joints at the end of the follow-up period and were considered as radiological responders (RR). Serum levels of GRO-a and RANTES after 6 months of treatment were significantly higher among the patients with radiological progression than in RR patients.

Conclusions
We observed high levels of serum RANTES in a series of RA patients during the active stage of the disease. MTX treatment significantly lowered the serum levels of RANTES, GRO-a and MCP-1. High levels of serum RANTES or GRO-a after 6 months of MTX treatment seem to be predictive of radiological erosions after one year.

Key words
Rheumatoid arthritis, methotrexate, serum chemokines.

This study was supported by grants from Ricerca Corrente, Istituti Ortopedici Rizzoli, Bologna and the Associazione Studio Malattie Reumatiche "Luca da Reggio", Reggio Emilia, Italy.

Please address correspondence and reprint requests to: Dr. Pierluigi Macchioni, Servizio di Reumatologia, Azienda Ospedaliera Arcispedale Santa Maria Nuova, viale Umberto I no. 50, 42100, Reggio Emilia, Italy.