Volume 65, Issue 1 pp. 81-87
Rheumatoid Arthritis

Impact of the CTLA-4/CD28 axis on the processes of joint inflammation in rheumatoid arthritis

Dezsö Körmendy

Dezsö Körmendy

Charité Universitätsmedizin Berlin and Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany

Mr. Dezsö Körmendy and Dr. Holger Hoff contributed equally to this work.

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Holger Hoff

Holger Hoff

Charité Universitätsmedizin Berlin and Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany

Mr. Dezsö Körmendy and Dr. Holger Hoff contributed equally to this work.

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Paula Hoff

Paula Hoff

Charité Universitätsmedizin Berlin and Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany

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Barbara M. Bröker

Barbara M. Bröker

Universität Greifswald, Greifswald, Germany

Dr. Bröker has received consulting fees, speaking fees, and/or honoraria from Pfizer (less than $10,000) and receives licensing fees from Becton Dickinson for the use of BNI3 monoclonal antibodies.

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Gerd-Rüdiger Burmester

Gerd-Rüdiger Burmester

Charité Universitätsmedizin Berlin, Berlin, Germany

Dr. Burmester has received consulting fees and speaking fees from Bristol-Myers Squibb (less than $10,000).

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Monika C. Brunner-Weinzierl

Corresponding Author

Monika C. Brunner-Weinzierl

Charité Universitätsmedizin Berlin and Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany, and Otto-von-Guericke Universität Magdeburg, Magdeburg, Germany

Department of Pediatrics, Otto-von-Guericke Universität Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, GermanySearch for more papers by this author
First published: 08 October 2012
Citations: 29

Abstract

Objective

The importance of the costimulatory molecules CD28 and CTLA-4 in the pathologic mechanism of rheumatoid arthritis (RA) has been demonstrated by genetic associations and the successful clinical application of CTLA-4Ig for the treatment of RA. This study was undertaken to investigate the role of the CTLA-4/CD28 axis in the local application of CTLA-4Ig in the synovial fluid (SF) of RA patients.

Methods

Quantitative polymerase chain reaction was used to analyze the expression of proinflammatory and antiinflammatory cytokines in ex vivo fluorescence-activated cell sorted CTLA-4+ and CTLA-4− T helper cells from the peripheral blood and SF of RA patients. T helper cells were also analyzed for cytokine expression in vitro after the blockade of CTLA-4 by anti–CTLA-4 Fab fragments or of B7 (CD80/CD86) molecules by CTLA-4Ig.

Results

CTLA-4+ T helper cells were unambiguously present in the SF of all RA patients examined, and they expressed increased amounts of interferon-γ (IFNγ), interleukin-17 (IL-17), and IL-10 as compared to CTLA-4− T helper cells. The selective blockade of CTLA-4 in T helper cells from the SF in vitro led to increased levels of IFNγ, IL-2, and IL-17. The concomitant blockade of CD28 and CTLA-4 in T helper cells from RA SF by CTLA-4Ig in vitro resulted in reduced levels of the proinflammatory cytokines IFNγ and IL-2 and increased levels of the antiinflammatory cytokines IL-10 and transforming growth factor β.

Conclusion

Our ex vivo and in vitro results demonstrate that the CTLA-4/CD28 axis constitutes a drug target for not only the systemic, but potentially also the local, application of the costimulation blocking agent CTLA-4Ig for the treatment of RA.

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