There have been some publications on adipokines at the ACR 2015 Annual
Meeting in San Francisco, but I’ll restrict myself to the two studies related
to rheumatoid arthritis.
Adipokines are cytokines and hormones, which are primarily synthesized
in white adipose tissue. Some adipokines have already been identified to be associated
with bad outcomes in rheumatoid arthritis. Lean people with a normal metabolic
function produce anti-inflammatory adipokines, whereas obese people with mild
metabolic dysfunction produce anti- and pro-inflammatory adipokines. Obese
people with marked metabolic dysfunction produce pro-inflammatory cytokines
etc. like TNF-alpha, IL-6, CCL2, CXCL5, leptin, resistin, to name a few.
Adrian Levitsky and colleagues presented: “Adipokines and Insulin-like
Growth Factor 1 As Predictors of Clinical and Radiographic Outcomes in Early
Rheumatoid Arthritis”. The authors looked at serum levels of adiponectin,
leptin, IGF-1, and resistin of patients enrolled in the SWEFOT trial. Conclusion:
“Differences in certain adipokines and IGF-1 were associated with clinical and
radiographic outcomes within specific treatment groups. Thus, they may be
useful predictors and may give insight into pathogenic mechanisms influencing
RA outcomes such as high BMI and disease activity.” Please have a look at the
charts yourself and you might agree that the first sentence of conclusion is
correct, but the rest is speculation. Right now we can’t identify radiographic progressors
by adipokines at baseline. But “may be in the future” is strong enough to wish
the authors and other teams good luck and persistence.
Rebecca Hasseli and colleagues looked at: “The Influence of Adipokines
on the Interaction of Rheumatoid Arthritis Synovial Fibroblasts with
Endothelial Cells”. Methods: “Primary RASF [rheumatoid arthritis synovial
fibroblasts] and EC [endothelial cells] were stimulated with adiponectin (10
µg/ml), visfatin (100 ng/ml) and resistin (20 ng/ml) as well as with MTX (1.5
µM) and the glucocorticoids prednisolone (1 µM) and dexamethasone (1 µM). […]”Conclusion:
„Adipokines have an influence on the cellular expression of adhesion molecules
on RASF and EC as well as their interaction. Adipokines increase adhesion of
RASF to EC and therefore influence RASF migration. Therapeutics such as
glucocorticoids and MTX antagonized these effects, which may represent a
mechanism of the protective effects of these drugs observed in patients. […]”
What can we take out of these studies? Knowledge on adipokines will
certainly influence our approach to rheumatoid arthritis in the future. I’d
like to suggest more effort in psoriatic arthritis and adipokines as in this
group of patients the level of metabolic dysfunction is especially high.
References:
Levitsky A, Brismar K, Saevarsdottir S, Hambardzumyan K, Andersson A,
van Vollenhoven RF. Adipokines and Insulin-like Growth Factor 1 As Predictors
of Clinical and Radiographic Outcomes in Early Rheumatoid Arthritis [abstract].
Arthritis Rheumatol. 2015; 67 (suppl
10). http://acrabstracts.org/abstract/adipokines-and-insulin-like-growth-factor-1-as-predictors-of-clinical-and-radiographic-outcomes-in-early-rheumatoid-arthritis/.
Accessed December 5, 2015.
Hasseli R, Frommer KW, Umscheid T, Schönburg M, Rehart S, Müller-Ladner
U, Neumann E. The Influence of Adipokines on the Interaction of Rheumatoid
Arthritis Synovial Fibroblasts with Endothelial Cells [abstract]. Arthritis Rheumatol. 2015; 67 (suppl
10). http://acrabstracts.org/abstract/the-influence-of-adipokines-on-the-interaction-of-rheumatoid-arthritis-synovial-fibroblasts-with-endothelial-cells/.
Accessed December 5, 2015.
Chialà A, Rotondo C, Anelli MG, Praino E, Cantarini L, Scioscia C,
Giannini M, Lapadula G, Iannone F. Evaluation of Serum Levels of Adipokines and
Interleukines in Pericardial Effusion Related to Systemic Sclerosis [abstract].
Arthritis Rheumatol. 2015; 67 (suppl
10). http://acrabstracts.org/abstract/evaluation-of-serum-levels-of-adipokines-and-interleukines-in-pericardial-effusion-related-to-systemic-sclerosis/.
Accessed December 5, 2015.
Korman B, Goncalves Marangoni R, Hinchcliff ME, Shah S, Carns MA,
Ramsey-Goldman R, Varga J. Association of Serum Adipokines Adipsin,
Adiponectin, and Leptin/Adiponectin Ratio with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl
10). http://acrabstracts.org/abstract/association-of-serum-adipokines-adipsin-adiponectin-and-leptinadiponectin-ratio-with-systemic-sclerosis/.
Accessed December 5, 2015.
Ferreira da Silva T, Levy Neto M, Caparbo V, Takayama L, Pereira RMR. Abnormal
Body Composition in Takayasu Arteritis Patients: Role of Inflammatory Cytokines
and Adipokines [abstract]. Arthritis
Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/abnormal-body-composition-in-takayasu-arteritis-patients-role-of-inflammatory-cytokines-and-adipokines/.
Accessed December 5, 2015.
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