Investigation of autoantigens in patients with rheumatoid arthritis through protemic analysis: exploration from diagnosis, pathogenesis to therapy

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Serum immune complexome analysis has found that TSP-1 and PF-4 are candidate autoantigens in RA. Especially, TSP-1 was considered as more useful than PF-4 in terms of detection sensitivity. In fact, prominent expression of TSP-1 was found in RA synovial tissues. TSP-1 was spontaneously produced in RA synovial cells and TGF- beta1 significantly stimulated the synthesis of TSP-1 at transcriptional level. A clear reduction of plasma TSP-1 and TGF- beta1 was found in RA patients successfully treated by disease-modifying anti-rheumatic drugs (DMARDs), however, the above change was not determined in RA patients DMARDs did not improve the clinical disease activity. It has been reported that the inflammatory niche of rheumatoid synovial tissues contain high TGF- beta1. We suspect that TGF- beta1 acts on synovial cells to produce TSP-1, and furthermore, the augmented production of TSP-1 may stimulate the autoantibody production toward TSP-1 in patients with RA.