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To investigate the presence, phenotype and role of synovial macrophages in SpA by immunohistochemistry and flowcytometry.
In the synovial lining CD68, CD163 and HLA-DR were increased in SpA versus RA; in the sublining CD163 and HLA-DR were also increased. In contrast, costimulatory molecules and dendritic cell markers were scarce in SpA versus RA synovium. Interestingly, CD163 and CD68 were also increased in colonic lamina propria in SpA. CD163 and HLA-DR in the sublining were correlated with CRP and ESR. CD163+ macrophages expressed high levels of HLA-DR and could produce TNF-alpha but not IL-10. Anti-TNF-alpha therapy in SpA induced a decrease of CD163 in both synovial lining and sublining.
Macrophages expressing the scavenger receptor CD163 are increased in synovium and colonic mucosa in SpA, highlighting the relation between joint and gut. The correlation with inflammatory parameters, the expression of HLA-DR, the production of TNF-alpha but not IL-10 and the reduction by anti-TNF-alpha therapy support a role for CD163+ macrophages in synovial inflammation in SpA.