Synovial fluid from patients with rheumatoid arthritis modulates monocyte cell-surface phenotype.

Objectives To investigate the ability of synovial fluid from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) to modulate cell-surface phenotype, function and viability of monocytes. Methods Monocytes from healthy donors were incubated with synovial fluid from patients with RA or OA. These were then cultured with autologous healthy CD4+ T-cells. Immunoglobulin-like transcript 4 (ILT4) and CD86 were evaluated on stimulated monocytes and CD4+ T-cells via fluorescence activated cell sorting. Results Monocytes incubated with synovial fluid from patients with RA (SF-RA; n=12) had significantly lower ILT4 and higher CD86 levels than those incubated with synovial fluid from patients with OA (SF-OA; n=12) or medium alone. In patients with RA, there was a significant negative correlation between ILT4 and disease activity score (DAS; r=-0.699), and a positive correlation between CD86 and DAS (r=0.626). T-cells costimulated with monocytes cultured with SF-RA produced significantly more interferon- and tumour necrosis factor- than those costimulated with monocytes cultured with SF-OA or controls. Conclusions Soluble mediators in SF-RA could contribute to modulating inflammation and local effectiveness of the immune response.