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Erschienen in: Clinical Rheumatology 8/2007

01.08.2007 | Original Article

Distinct expression of mast cell tryptase and protease activated receptor-2 in synovia of rheumatoid arthritis and osteoarthritis

verfasst von: Shunji Nakano, Takuya Mishiro, Shigeyuki Takahara, Hiromichi Yokoi, Daisuke Hamada, Kiminori Yukata, Yoichiro Takata, Tomohiro Goto, Hiroshi Egawa, Susumu Yasuoka, Harumi Furouchi, Katsuya Hirasaka, Takeshi Nikawa, Natsuo Yasui

Erschienen in: Clinical Rheumatology | Ausgabe 8/2007

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Abstract

The objective of this study is to examine the differential expression of mast cell tryptase and its receptor, protease-activated receptor-2 (PAR-2), in the synovium and synovial fluid of patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Biochemical and immunohistochemical analyses were performed to determine whether the trypsin-like protease in the synovium is identical to mast cell tryptase. The effects of mast cell tryptase on the proliferation of synovial fibroblast-like cells (SFCs) and the release of IL-8 thereof were evaluated by the [3H]-thymidine incorporation and ELISA, respectively. The trypsin-like protease in the synovium of RA patients was identical to human mast cell tryptase, which was composed of two subunits: 33 and 34 kDa. The 33- and 34-kDa proteins are different glycosylated forms of the 31-kDa protein, which was unglycosylated. Mast cell tryptase activity in RA synovial fluid was significantly higher than that in OA synovial fluid, while their activities and expression in the synovium were similar. Expression of PAR-2 mRNA in the synovium was higher in RA than in OA. Mast cell tryptase containing the unglycosylated 31-kDa subunit was the predominant form in synovial fluid. RA patients had higher amounts of this subunit in their synovial fluid than OA patients. Mast cell tryptase and PAR-2 activating peptide stimulated the proliferation of SFCs and release of IL-8 from these cells. Mast cell tryptase secretion into RA synovial fluid is higher than OA synovial fluid. Mast cell tryptase in synovial fluid stimulates the proliferation of SFCs and the release of pro-inflammatory cytokines via PAR-2, which may contribute to exacerbation of synovitis in RA.
Literatur
1.
Zurück zum Zitat Malone DG, Wilder RL, Saavedra-Delgado AM, Metcalfe DD (1987) Mast cell numbers in rheumatoid synovial tissues. Correlations with quantitative measures of lymphocytic infiltration and modulation by antiinflammatory therapy. Arthritis Rheum 30:130–137PubMedCrossRef Malone DG, Wilder RL, Saavedra-Delgado AM, Metcalfe DD (1987) Mast cell numbers in rheumatoid synovial tissues. Correlations with quantitative measures of lymphocytic infiltration and modulation by antiinflammatory therapy. Arthritis Rheum 30:130–137PubMedCrossRef
2.
Zurück zum Zitat Gruber BL, Schwartz LB, Ramamurthy NS, Irani AM, Marchese MJ (1988) Activation of latent rheumatoid synovial collagenase by human mast cell tryptase. J Immunol 140:3936–3942PubMed Gruber BL, Schwartz LB, Ramamurthy NS, Irani AM, Marchese MJ (1988) Activation of latent rheumatoid synovial collagenase by human mast cell tryptase. J Immunol 140:3936–3942PubMed
3.
Zurück zum Zitat Bridges AJ, Malone DG, Jicinsky J, Chen M, Ory P, Engber W et al (1991) Human synovial mast cell involvement in rheumatoid arthritis and osteoarthritis. Relationship to disease type, clinical activity, and antirheumatic therapy. Arthritis Rheum 34:1116–1124PubMedCrossRef Bridges AJ, Malone DG, Jicinsky J, Chen M, Ory P, Engber W et al (1991) Human synovial mast cell involvement in rheumatoid arthritis and osteoarthritis. Relationship to disease type, clinical activity, and antirheumatic therapy. Arthritis Rheum 34:1116–1124PubMedCrossRef
4.
Zurück zum Zitat Dean G, Hoyland JA, Denton J, Donn RP, Freemont AJ (1993) Mast cells in the synovium and synovial fluid in osteoarthritis. Br J Rheumatol 32:671–675PubMedCrossRef Dean G, Hoyland JA, Denton J, Donn RP, Freemont AJ (1993) Mast cells in the synovium and synovial fluid in osteoarthritis. Br J Rheumatol 32:671–675PubMedCrossRef
5.
Zurück zum Zitat Tetlow LC, Woolley DE (1995) Distribution, activation and tryptase/chymase phenotype of mast cells in the rheumatoid lesion. Ann Rheum Dis 54:549–555PubMed Tetlow LC, Woolley DE (1995) Distribution, activation and tryptase/chymase phenotype of mast cells in the rheumatoid lesion. Ann Rheum Dis 54:549–555PubMed
6.
Zurück zum Zitat de Paulis A, Marino I, Ciccarelli A, de Crescenzo G, Concardi M, Verga L et al (1996) Human synovial mast cells. I. Ultrastructural in situ and in vitro immunologic characterization. Arthritis Rheum 39:1222–1233PubMedCrossRef de Paulis A, Marino I, Ciccarelli A, de Crescenzo G, Concardi M, Verga L et al (1996) Human synovial mast cells. I. Ultrastructural in situ and in vitro immunologic characterization. Arthritis Rheum 39:1222–1233PubMedCrossRef
7.
Zurück zum Zitat Buckley MG, Gallagher PJ, Walls AF (1998) Mast cell subpopulations in the synovial tissue of patients with osteoarthritis: selective increase in numbers of tryptase-positive, chymase-negative mast cells. J Pathol 186:67–74PubMedCrossRef Buckley MG, Gallagher PJ, Walls AF (1998) Mast cell subpopulations in the synovial tissue of patients with osteoarthritis: selective increase in numbers of tryptase-positive, chymase-negative mast cells. J Pathol 186:67–74PubMedCrossRef
8.
Zurück zum Zitat Gotis-Graham I, Smith MD, Parker A, McNeil HP (1998) Synovial mast cell responses during clinical improvement in early rheumatoid arthritis. Ann Rheum Dis 57:664–671PubMedCrossRef Gotis-Graham I, Smith MD, Parker A, McNeil HP (1998) Synovial mast cell responses during clinical improvement in early rheumatoid arthritis. Ann Rheum Dis 57:664–671PubMedCrossRef
9.
Zurück zum Zitat Woolley DE, Tetlow LC (2000) Mast cell activation and its relation to proinflammatory cytokine production in the rheumatoid lesion. Arthritis Res 2:65–74PubMedCrossRef Woolley DE, Tetlow LC (2000) Mast cell activation and its relation to proinflammatory cytokine production in the rheumatoid lesion. Arthritis Res 2:65–74PubMedCrossRef
10.
Zurück zum Zitat Schwartz LB (1994) Tryptase: a mast cell serine protease. Methods Enzymol 244:88–100PubMed Schwartz LB (1994) Tryptase: a mast cell serine protease. Methods Enzymol 244:88–100PubMed
11.
Zurück zum Zitat Smith TJ, Hougland MW, Johnson DA (1984) Human lung tryptase. Purification and characterization. J Biol Chem 259:11046–11051PubMed Smith TJ, Hougland MW, Johnson DA (1984) Human lung tryptase. Purification and characterization. J Biol Chem 259:11046–11051PubMed
12.
Zurück zum Zitat Asokananthan N, Graham PT, Fink J, Knight DA, Bakker AJ, McWilliam AS et al (2002) Activation of protease-activated receptor (PAR)-1, PAR-2, and PAR-4 stimulates IL-6, IL-8, and prostaglandin E2 release from human respiratory epithelial cells. J Immunol 168:3577–3585 Asokananthan N, Graham PT, Fink J, Knight DA, Bakker AJ, McWilliam AS et al (2002) Activation of protease-activated receptor (PAR)-1, PAR-2, and PAR-4 stimulates IL-6, IL-8, and prostaglandin E2 release from human respiratory epithelial cells. J Immunol 168:3577–3585
13.
Zurück zum Zitat D’Andrea MR, Rogahn CJ, Andrade-Gordon P (2000) Localization of protease-activated receptors-1 and -2 in human mast cells: indications for an amplified mast cell degranulation cascade. Biotech Histochem 75:85–90PubMed D’Andrea MR, Rogahn CJ, Andrade-Gordon P (2000) Localization of protease-activated receptors-1 and -2 in human mast cells: indications for an amplified mast cell degranulation cascade. Biotech Histochem 75:85–90PubMed
14.
Zurück zum Zitat Smith R, Ransjo M, Tatarczuch L, Song SJ, Pagel C, Morrison JR et al (2004) Activation of protease-activated receptor-2 leads to inhibition of osteoclast differentiation. J Bone Miner Res 19:507–516PubMedCrossRef Smith R, Ransjo M, Tatarczuch L, Song SJ, Pagel C, Morrison JR et al (2004) Activation of protease-activated receptor-2 leads to inhibition of osteoclast differentiation. J Bone Miner Res 19:507–516PubMedCrossRef
15.
Zurück zum Zitat Steinhoff M, Neisius U, Ikoma A, Fartasch M, Heyer G, Skov PS et al (2003) Proteinase-activated receptor-2 mediates itch: a novel pathway for pruritus in human skin. J Neurosci 23:6176–6180PubMed Steinhoff M, Neisius U, Ikoma A, Fartasch M, Heyer G, Skov PS et al (2003) Proteinase-activated receptor-2 mediates itch: a novel pathway for pruritus in human skin. J Neurosci 23:6176–6180PubMed
16.
Zurück zum Zitat Uehara A, Muramoto K, Takada H, Sugawara S (2003) Neutrophil serine proteinases activate human nonepithelial cells to produce inflammatory cytokines through protease-activated receptor 2. J Immunol 170:5690–5696PubMed Uehara A, Muramoto K, Takada H, Sugawara S (2003) Neutrophil serine proteinases activate human nonepithelial cells to produce inflammatory cytokines through protease-activated receptor 2. J Immunol 170:5690–5696PubMed
17.
Zurück zum Zitat Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRef Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRef
18.
Zurück zum Zitat Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum 29:1039–1049PubMedCrossRef Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum 29:1039–1049PubMedCrossRef
19.
Zurück zum Zitat Nakano S, Ikata T, Kinoshita I, Kanematsu J, Yasuoka S (1999) Characteristics of the protease activity in synovial fluid from patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol 17:161–170PubMed Nakano S, Ikata T, Kinoshita I, Kanematsu J, Yasuoka S (1999) Characteristics of the protease activity in synovial fluid from patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol 17:161–170PubMed
20.
Zurück zum Zitat Yasuoka S, Ohnishi T, Kawano S, Tsuchihashi S, Ogawara M, Masuda K et al (1997) Purification, characterization, and localization of a novel trypsin-like protease found in the human airway. Am J Respir Cell Mol Biol 16:300–308PubMed Yasuoka S, Ohnishi T, Kawano S, Tsuchihashi S, Ogawara M, Masuda K et al (1997) Purification, characterization, and localization of a novel trypsin-like protease found in the human airway. Am J Respir Cell Mol Biol 16:300–308PubMed
21.
Zurück zum Zitat Suzue N, Nikawa T, Onishi Y, Yamada C, Hirasaka K, Ogawa T et al (2006) Ubiquitin ligase Cbl-b downregulates bone formation through suppression of IGF-I signaling in osteoblasts during denervation. J Bone Miner Res 21:722–734PubMedCrossRef Suzue N, Nikawa T, Onishi Y, Yamada C, Hirasaka K, Ogawa T et al (2006) Ubiquitin ligase Cbl-b downregulates bone formation through suppression of IGF-I signaling in osteoblasts during denervation. J Bone Miner Res 21:722–734PubMedCrossRef
22.
Zurück zum Zitat Nikawa T, Towatari T, Katunuma N (1992) Purification and characterization of cathepsin J from rat liver. Eur J Biochem 204:381–393PubMedCrossRef Nikawa T, Towatari T, Katunuma N (1992) Purification and characterization of cathepsin J from rat liver. Eur J Biochem 204:381–393PubMedCrossRef
23.
Zurück zum Zitat Mishiro T, Nakano S, Takahara S, Miki M, Nakamura Y, Yasuoka S et al (2004) Relationship between cathepsin B and thrombin in rheumatoid arthritis. J Rheumatol 31:1265–1273PubMed Mishiro T, Nakano S, Takahara S, Miki M, Nakamura Y, Yasuoka S et al (2004) Relationship between cathepsin B and thrombin in rheumatoid arthritis. J Rheumatol 31:1265–1273PubMed
24.
Zurück zum Zitat Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the folin phenol reagent. J Biol Chem 193:265–275PubMed Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the folin phenol reagent. J Biol Chem 193:265–275PubMed
25.
Zurück zum Zitat Cromlish JA, Seidah NG, Marcinkiewicz M, Hamelin J, Johnson DA, Chretien M (1987) Human pituitary tryptase: molecular forms, NH2-terminal sequence, immunocytochemical localization, and specificity with prohormone and fluorogenic substrates. J Biol Chem 262:1363–1373PubMed Cromlish JA, Seidah NG, Marcinkiewicz M, Hamelin J, Johnson DA, Chretien M (1987) Human pituitary tryptase: molecular forms, NH2-terminal sequence, immunocytochemical localization, and specificity with prohormone and fluorogenic substrates. J Biol Chem 262:1363–1373PubMed
26.
Zurück zum Zitat Bradding P, Okayama Y, Howarth PH, Church MK, Holgate ST (1995) Heterogeneity of human mast cells based on cytokine content. J Immunol 155:297–307PubMed Bradding P, Okayama Y, Howarth PH, Church MK, Holgate ST (1995) Heterogeneity of human mast cells based on cytokine content. J Immunol 155:297–307PubMed
27.
Zurück zum Zitat Little SS, Johnson DA (1995) Human mast cell tryptase isoforms: separation and examination of substrate-specificity differences. Biochem J 307 (Pt 2):341–346PubMed Little SS, Johnson DA (1995) Human mast cell tryptase isoforms: separation and examination of substrate-specificity differences. Biochem J 307 (Pt 2):341–346PubMed
28.
Zurück zum Zitat Schwartz LB, Sakai K, Bradford TR, Ren S, Zweiman B, Worobec AS et al (1995) The alpha form of human tryptase is the predominant type present in blood at baseline in normal subjects and is elevated in those with systemic mastocytosis. J Clin Invest 96:2702–2710PubMed Schwartz LB, Sakai K, Bradford TR, Ren S, Zweiman B, Worobec AS et al (1995) The alpha form of human tryptase is the predominant type present in blood at baseline in normal subjects and is elevated in those with systemic mastocytosis. J Clin Invest 96:2702–2710PubMed
29.
Zurück zum Zitat Buckley MG, Walters C, Wong WM, Cawley MI, Ren S, Schwartz LB et al (1997) Mast cell activation in arthritis: detection of alpha- and beta-tryptase, histamine and eosinophil cationic protein in synovial fluid. Clin Sci (Lond) 93:363–370 Buckley MG, Walters C, Wong WM, Cawley MI, Ren S, Schwartz LB et al (1997) Mast cell activation in arthritis: detection of alpha- and beta-tryptase, histamine and eosinophil cationic protein in synovial fluid. Clin Sci (Lond) 93:363–370
30.
Zurück zum Zitat de Paulis A, Ciccarelli A, Marino I, de Crescenzo G, Marino D, Marone G (1997) Human synovial mast cells. II. Heterogeneity of the pharmacologic effects of antiinflammatory and immunosuppressive drugs. Arthritis Rheum 40:469–478PubMedCrossRef de Paulis A, Ciccarelli A, Marino I, de Crescenzo G, Marino D, Marone G (1997) Human synovial mast cells. II. Heterogeneity of the pharmacologic effects of antiinflammatory and immunosuppressive drugs. Arthritis Rheum 40:469–478PubMedCrossRef
31.
Zurück zum Zitat Chen Y, Shiota M, Ohuchi M, Towatari T, Tashiro J, Murakami M et al (2000) Mast cell tryptase from pig lungs triggers infection by pneumotropic Sendai and influenza A viruses. Purification and characterization. Eur J Biochem 267:3189–3197PubMedCrossRef Chen Y, Shiota M, Ohuchi M, Towatari T, Tashiro J, Murakami M et al (2000) Mast cell tryptase from pig lungs triggers infection by pneumotropic Sendai and influenza A viruses. Purification and characterization. Eur J Biochem 267:3189–3197PubMedCrossRef
32.
Zurück zum Zitat Peng Q, McEuen AR, Benyon RC, Walls AF (2003) The heterogeneity of mast cell tryptase from human lung and skin. Eur J Biochem 270:270–283PubMedCrossRef Peng Q, McEuen AR, Benyon RC, Walls AF (2003) The heterogeneity of mast cell tryptase from human lung and skin. Eur J Biochem 270:270–283PubMedCrossRef
33.
Zurück zum Zitat Kiener HP, Baghestanian M, Dominkus M, Walchshofer S, Ghannadan M, Willheim M et al (1998) Expression of the C5a receptor (CD88) on synovial mast cells in patients with rheumatoid arthritis. Arthritis Rheum 41:233–245PubMedCrossRef Kiener HP, Baghestanian M, Dominkus M, Walchshofer S, Ghannadan M, Willheim M et al (1998) Expression of the C5a receptor (CD88) on synovial mast cells in patients with rheumatoid arthritis. Arthritis Rheum 41:233–245PubMedCrossRef
34.
Zurück zum Zitat Orlean P (1992) Enzymes that recognize dolichols participate in three glycosylation pathways and are required for protein secretion. Biochem Cell Biol 70(6):438–447PubMedCrossRef Orlean P (1992) Enzymes that recognize dolichols participate in three glycosylation pathways and are required for protein secretion. Biochem Cell Biol 70(6):438–447PubMedCrossRef
35.
Zurück zum Zitat Kukuruzinska MA, Lennon K (1998) Protein N-glycosylation: molecular genetics and functional significance. Crit Rev Oral Biol Med 9:415–448PubMed Kukuruzinska MA, Lennon K (1998) Protein N-glycosylation: molecular genetics and functional significance. Crit Rev Oral Biol Med 9:415–448PubMed
36.
Zurück zum Zitat Brodsky JL (2005) An in vitro assay for the selective endoplasmic reticulum associated degradation of an unglycosylated secreted protein. Methods 35:354–359PubMedCrossRef Brodsky JL (2005) An in vitro assay for the selective endoplasmic reticulum associated degradation of an unglycosylated secreted protein. Methods 35:354–359PubMedCrossRef
37.
Zurück zum Zitat Sareneva T, Pirhonen J, Cantell K, Kalkkinen N, Julkunen I (1994) Role of N-glycosylation in the synthesis, dimerization and secretion of human interferon-gamma. Biochem J 303:831–840PubMed Sareneva T, Pirhonen J, Cantell K, Kalkkinen N, Julkunen I (1994) Role of N-glycosylation in the synthesis, dimerization and secretion of human interferon-gamma. Biochem J 303:831–840PubMed
38.
Zurück zum Zitat Hirooka T, Suganuma N, Furuhashi M, Kitagawa T, Ando H, Kikkawa F et al (1996) Synthesis and release of glycosylated prolactin in transfected cells with human prolactin complementary deoxyribonucleic acid. Endocr J 43:423–428PubMedCrossRef Hirooka T, Suganuma N, Furuhashi M, Kitagawa T, Ando H, Kikkawa F et al (1996) Synthesis and release of glycosylated prolactin in transfected cells with human prolactin complementary deoxyribonucleic acid. Endocr J 43:423–428PubMedCrossRef
39.
Zurück zum Zitat Ferrell WR, Lockhart JC, Kelso EB, Dunning L, Plevin R, Meek SE et al (2003) Essential role for proteinase-activated receptor-2 in arthritis. J Clin Invest 111:35–41PubMedCrossRef Ferrell WR, Lockhart JC, Kelso EB, Dunning L, Plevin R, Meek SE et al (2003) Essential role for proteinase-activated receptor-2 in arthritis. J Clin Invest 111:35–41PubMedCrossRef
40.
Zurück zum Zitat Matsushima R, Takahashi A, Nakaya Y, Maezawa H, Miki M, Nakamura Y et al (2006) Human airway trypsin-like protease stimulates human bronchial fibroblast proliferation in a protease-activated receptor-2-dependent pathway. Am J Physiol Lung Cell Mol Physiol 290:L385–L395PubMedCrossRef Matsushima R, Takahashi A, Nakaya Y, Maezawa H, Miki M, Nakamura Y et al (2006) Human airway trypsin-like protease stimulates human bronchial fibroblast proliferation in a protease-activated receptor-2-dependent pathway. Am J Physiol Lung Cell Mol Physiol 290:L385–L395PubMedCrossRef
41.
Zurück zum Zitat Dery O, Corvera CU, Steinhoff M, Bunnett NW (1998) Proteinase-activated receptors: novel mechanisms of signaling by serine proteases. Am J Physiol 274:C1429–C1452PubMed Dery O, Corvera CU, Steinhoff M, Bunnett NW (1998) Proteinase-activated receptors: novel mechanisms of signaling by serine proteases. Am J Physiol 274:C1429–C1452PubMed
42.
Zurück zum Zitat Hirano F, Kobayashi A, Hirano Y, Nomura Y, Fukawa E, Makino I (2002) Thrombin-induced expression of RANTES mRNA through protease activated receptor-1 in human synovial fibroblasts. Ann Rheum Dis 61:834–837PubMedCrossRef Hirano F, Kobayashi A, Hirano Y, Nomura Y, Fukawa E, Makino I (2002) Thrombin-induced expression of RANTES mRNA through protease activated receptor-1 in human synovial fibroblasts. Ann Rheum Dis 61:834–837PubMedCrossRef
43.
Zurück zum Zitat Yang YH, Hall P, Little CB, Fosang AJ, Milenkovski G, Santos L et al (2005) Reduction of arthritis severity in protease-activated receptor-deficient mice. Arthritis Rheum 52:1325–1332PubMedCrossRef Yang YH, Hall P, Little CB, Fosang AJ, Milenkovski G, Santos L et al (2005) Reduction of arthritis severity in protease-activated receptor-deficient mice. Arthritis Rheum 52:1325–1332PubMedCrossRef
Metadaten
Titel
Distinct expression of mast cell tryptase and protease activated receptor-2 in synovia of rheumatoid arthritis and osteoarthritis
verfasst von
Shunji Nakano
Takuya Mishiro
Shigeyuki Takahara
Hiromichi Yokoi
Daisuke Hamada
Kiminori Yukata
Yoichiro Takata
Tomohiro Goto
Hiroshi Egawa
Susumu Yasuoka
Harumi Furouchi
Katsuya Hirasaka
Takeshi Nikawa
Natsuo Yasui
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 8/2007
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-006-0495-8

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