CYTOKINES AND ADHESION MOLECULES IN PATIENTS WITH POLYMYALGIA-RHEUMATICA

Serum levels of interleukin-1 beta (IL-1 beta), IL-1 receptor antagoni st (IL-1ra), tumour necrosis factor alpha (TNF-alpha), IL-6, soluble I L-6 receptor (sIL-6R), soluble intercellular adhesion molecule-1 (sICA M-1) and soluble E-selectin were measured in 15 patients with newly di agnosed polymyalgia rheumatica (PMR) before and after 3 months of cort icosteroid therapy. Both IL-6 and IL-1ra were significantly increased in untreated PMR and remained elevated compared with controls during t herapy, although significantly only for sIL-1ra. sICAM-1 was raised in 12/15 (87%) patients at diagnosis and remained high in 10/14 (71%) pa tients; soluble E-selectin levels were initially raised in 6/15 (40%) patients and decreased with therapy in those with the highest levels. IL-6, IL-1ra and sICAM-1 are sensitive indicators of continuing immuno logical activation in PMR; the advantages of these markers in assessin g the response to therapy should be investigated in a longitudinal stu dy.