Title:Synovial Fluid and Serum Concentrations of Inflammatory Markers in Rheumatoid Arthritis, Psoriatic Arthritis and Osteoarthitis: A Systematic Review
VOLUME: 13 ISSUE: 3
Author(s):Emma Altobelli*, Paolo Matteo Angeletti, Domenico Piccolo and Rossella De Angelis
Affiliation:Departments of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Departments of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Departments of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Rheumatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona
Keywords:Synovial fluid, markers, psoriatic arthritis, inflammation, systematic review, RA patients.
Abstract:Background: The aim of this review is to investigate systematically the presence of the
most extensively studied Synovial Fluid (SF) and/or serum markers in patients with Rheumatoid
Arthritis (RA), Psoriatic Arthritis (PsA) and Osteoarthritis (OA), and their associations and
correlations with laboratory and clinical data, with a view to providing insights for future research.
Objective: Papers were selected using the PRISMA flow-chart. Search of the electronic databases
according to the above criteria found a total of 55 papers. Examination led to the exclusion of 39 papers.
Finally, 16 studies met the inclusion criteria and are reviewed. As regards to interleukins we
found: Higher TNF-α levels in patients with early RA and PsA than in those with osteoarthritis
(p<0.05); higher IL-6 levels in patients with inflammatory arthritis (RA and PsA) than in those with
OA (p=0.032) and higher IL-17 levels in SF from PsA patients than RA patients (p=0.04) and a significant
difference in serum levels between PsA patients and healthy controls (p=0.013) and higher
IL-22 SF levels in PsA than OA patients (p<0.001) and in RA compared with OA patients (p<0.01).
As regards chemokine, CCL-22 was higher in SF from RA and PsA patients than in OA patients
(p<0.01).
Method: Considering the sample size of the studies reviewed here, their findings need confirmation in
larger samples, while the potential prognostic value of SF and/or serum biomarkers requires prospective
investigation.
Conclusion: The limitations of the biological SF assays and the problems encountered in the
attempted use of cytokine assays for diagnostic purposes must be addressed.
