Indian Journal of Clinical Biochemistry

, Volume 21, Issue 2, pp 49–52 | Cite as

Positive influence of Methotrexate-Hydroxychloroquine combination on the expression of GM-CSF receptor on neutrophils of synovial fluid in rheumatoid arthritis

  • Ananth N Rao
  • Beena V. Shetty
  • D. M. Vasudevan


Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) has been inducted as a mediator of inflammation in rheumatoid arthritis. Methotrexate combination therapy forms an important component of the treatment regimen in rheumatoid arthritis. The present study was undertaken to evaluate the influence of Methotrexate-Hydroxychloroquine (MTX-HCQ) combination and Sulfsalazine- Hydroxychloroquine (SSZ-HCQ) combination on the expression GM-CSFR in neutrophils isolated from synovial fluids. 15 cases of confirmed rheumatoid arthritis patients who presented at the hospital for surgical correction of joint deformities were selected for the study. Neutrophils isolated from the synovial fluids were used as the source of the receptor for quantitation on an enzyme immunoassay (EIA). The EIA was developed and standardized in our laboratory for quantification of the GM-CSF R. The findings are suggestive of the fact that the administration of MTX-HCQ combination has positive influence on the expression of the GM-CSF R on neutrophils as against SSZ-HCQ combination. The physiological basis of this increase needs further investigation.

Key words

Methotrexate Rheumatoid arthritis GM-CSF receptor Synovial fluid 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Weinblatt, M.E., Kaplan, H, Germain, B.F., et al. (1994) Methotrexate in rheumatoid arthritis: a five-year prospective multicenter study. Arthritis Rheum. 37, 1492–1498.PubMedCrossRefGoogle Scholar
  2. 2.
    O'Dell, J.R., Hairem, C.E., Erikson, N., et al. (1996) Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N. Engl. J. Med. 334, 1287–1291.PubMedCrossRefGoogle Scholar
  3. 3.
    Hamilton, J.A. (1993) Rheumatoid arthritis: opposing actions of haemopoietic growth factors and slow acting anti-rheumatic drugs. Lancet 342, 536–539.PubMedCrossRefGoogle Scholar
  4. 4.
    Gasson, J.C. (1991) Molecular physiology of granulocyte macrophage colony simulating factor. Blood 77, 1131–45.PubMedGoogle Scholar
  5. 5.
    Janeway, C.A., Travers, P., Walport, M., Schlomchik, M. (2001) Immunobiology; 5th edn. Garland Publishing.Google Scholar
  6. 6.
    Di, Persio, J., Billing, P., Kaufman, S., Eghtesady, P., Williams, R.C. and Casson, J.C. (1988) Characterisation of the human granulocyte macrophage colony stimulating receptor. J. Biol. Chem. 263(4), 1834–41.Google Scholar
  7. 7.
    Stacchini, A., Fubini, L. and Aglietta, M. (1996) Flow cytometric detection and quantitative analysis of the GM-CSF receptor in human granulocytes and comparison with radioligand binding assay. Cytometry 24(4), 374–81.PubMedCrossRefGoogle Scholar
  8. 8.
    Di Persio, J.F., Golde, D.W. and Gasson, J.D. (1990) GM-CSF: receptor structure and transmembrane signaling. Int. J. Cell-Cloning 74(5), 63–74.Google Scholar
  9. 9.
    Sidney, P., Colowick and Nathan, O., Kaplan (1984) Methods in Enzymology 105, 359–362.Google Scholar
  10. 10.
    Felson, D.T., Anderson, J.J. and Meenan, R.F. (1994) The efficacy and toxicity of combination therapy in rheumatoid arthritis, A meta-analysis. Arthritis Rheum. 37, 1487–1491.PubMedCrossRefGoogle Scholar
  11. 11.
    Boers, M., Verhoeven, A.C., Markusse, H.M. et al. (1997) Randomised comparison of combined step-down prednisolone, methotrexate and sulphsalazine alone in early rheumatoid arthritis. Lancet 350, 309–318.PubMedCrossRefGoogle Scholar
  12. 12.
    O'Dell, J.R., Haire, C.E., Palmer, W., et al. (1997) Treatment of early rheumatoid arthritis with minocycline or placebo. Arthritis Rheum. 40, 842–848.PubMedCrossRefGoogle Scholar
  13. 13.
    Tugwell, P., Pincus, T., Yocum, D., et al. (1995) Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthritis. N. Eng. J. Med. 333, 137–141.CrossRefGoogle Scholar
  14. 14.
    Alarcon, G.S., Tracy, I.C., Strand, G.M., et al. (1995) Survival and drug discontinuation analysis in a large cohort of methotrexate-treated rheumatoid arthritis patients. Ann. Rhem. Dis. 54, 708–712.CrossRefGoogle Scholar
  15. 15.
    Arend, W.P. (2001) Physiology of cytokine pathways in rheumatoid arthritis. Arthritis Rheum. 45, 101–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Xu, W.D., Firestein, G.S., Taetle, A., et al. (1989) Cytokines in chronic inflammatory arthritis. II granulocyte macrophage colony stimulating factor in rheumatoid synovial effusions. J. Clin. Invest. 83, 876–882.PubMedCrossRefGoogle Scholar
  17. 17.
    Field, M. and Clinton, L. (1993) Expression of GM-CSF receptor in rheumatoid arthritis (Letter). Lancet 342, 1244.PubMedCrossRefGoogle Scholar
  18. 18.
    Schimke, R.T. (1980) Gene amplification and drug resistance. Sci. Am. 243, 60–69.PubMedCrossRefGoogle Scholar

Copyright information

© Association of Clinical BIochemists of India 2006

Authors and Affiliations

  • Ananth N Rao
    • 1
  • Beena V. Shetty
    • 2
  • D. M. Vasudevan
    • 1
  1. 1.Department of BiochemistryAmrita Institute of Medical SciencesKochi
  2. 2.Kasturba Medical CollegeMangalore

Personalised recommendations