Background: Interleukin (IL)-20 is a pro-inflammatory cytokine that may be implicated in the pathogenesis of rheumatoid arthritis (RA). This study aimed to determine the association between IL-20 and disease activity in patients with RA.
Methods: The levels of serum and synovial fluid IL-20 were measured in patients with RA and OA. The disease activity was assessed based on the Disease Activity Score of 28 joints (DAS28).
The expression of IL-20 in synovial tissue samples from patients with RA and OA were determined by immunohistochemistry. Immunofluorescence staining was used to co-localize IL-20 with selected cells.
The secretion of IL-20 was analysed in human peripheral blood mononuclear cells (PBMCs) of patients with RA. Results: Synovial fluid and synovial tissue IL-20 were significantly increased in patients with RA compared with patients with OA.
The expression of IL-20 in RA synovial tissue was particularly associated with macrophages and neutrophil granulocytes, but also with synovial fibroblasts and lymphocytes. The IL-20 levels in synovial fluid correlated with DAS28 (r = 0.434; p = 0.015) and were significantly elevated in anti-CCP positive RA compared with anti-CCP negative RA (122.3 +/- 104.1 pg/ml and 45.9 +/- 35.8 pg/ml; p = 0.008).
IL-20 production from PBMCs was induced by Poly I:C and LPS but not with pro-inflammatory cytokines, such as TNF-alpha or IL-1. Conclusion: Our data showed that IL-20 is independently associated with RA disease activity and may be triggered by TLR ligands at local sites of inflammation.