Therapeutic research for osteoporosis with rheumatoid arthritis

目标。关节周围骨质疏松和关节破坏是类风湿性关节炎（RA）的主要并发症，由破骨细胞介导的骨吸收引起。然而，单核细胞破骨细胞成熟的机制和类风湿关节炎内皮细胞（RAEC）在控制破骨细胞发生中的作用尚不清楚。本研究旨在确定在raec产生的众多因素中影响单核细胞积累和破骨细胞形成的最重要因素。我们利用寡核苷酸芯片分析了不同器官（RA滑膜、脐静脉、皮肤、肝窦、肾小球和脑）内皮细胞中各种基因的表达谱。微阵列数据通过实时定量聚合酶链反应、酶联免疫吸附试验和RA滑膜免疫染色进行评估。用趋化室EZ-TAXIScanTM评估单核细胞的迁移。显微镜下观察到抗酒石酸酸性磷酸酶（TRAP）阳性的多核细胞形成。在众多上皮表达因子中，巨噬细胞集落刺激因子（M-CSF）基因在RAEC中特异表达。成纤维细胞生长因子-2 （FGF-2）基因在RAEC上也过表达。M-CSF中和抗体可抑制RAEC培养上清促进的单核细胞迁移和破骨细胞形成。RAEC产生的M-CSF参与单核细胞的破骨细胞生成；以及trap阳性的多核细胞形成，导致RA的联合破坏。

Objective. Periarticular osteoporosis and joint destruction are major complications in rheumatoid arthritis (RA), caused by osteoclast-mediated bone resorption. However, the mechanisms of monocyte osteoclast maturation and role of rheumatoid arthritis endothelial cells (RAEC) in the control of osteoclastogenesis remain unclear. The present study was designed to determine the most important factors that influence monocyte accumulation and osteoclast formation among the many factors produced by RAEC.Methods. We analyzed the expression profiles of various genes in human endothelial cells from various organs (RA synovium, umbilical vein, skin, liver sinusoid, renal glomerulus and brain) using oligonucleotide microarrays. The microarray data were assessed by real-time quantitative polymerase chain reaction, enzyme-linked immunosorbent assay, and immunostaining of RA synovia. Migration of monocytes was assessed by the chemotactic chamber EZ-TAXIScanTM. Tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cell formation was observed by microscopy.Results. Among many epithelial-expressed factors, macrophage-colony stimulating factor (M-CSF) gene was abundantly expressed specifically in RAEC. Fibroblast growth factor-2 (FGF-2) gene was also overexpressed on RAEC. Migration of monocytes and osteoclast formation in co-cultures promoted by culture supernatants of RAEC were inhibited by M-CSF neutralizing antibody.Conclusion. M-CSF produced by RAEC is involved in osteoclastogenesis from monocytes ; migration, and TRAP-positive multi-nuclear cell formation, resulting in joint destruction of RA.