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Vol. 33. Issue 7.
Pages 335-340 (July - August 1997)
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Vol. 33. Issue 7.
Pages 335-340 (July - August 1997)
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Producción de factor de necrosis tumoral alfa e interleucina 6 por los macrófagos alveolares de pacientes con artritis reumatoide y enfermedad pulmonar intersticial
Production of tumor necrosis factor-α and interleukin-6 by alveolar macrophages in patients with rheumatoid arthritis and interstitial lung disease
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J. Ancochea1, R.M. Girón
Servicios de Neumología. Hospital Universitario de la Princesa. Madrid
M. López-Botet*
* Servicios de Inmunología. Hospital Universitario de la Princesa. Madrid
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El objetivo de este estudio ha sido evaluar la producción de TNF- α e IL-6 por los macrófagos alveolares (MA) de pacientes con artritis reumatoide (AR) y enfermedad pulmonar intersticial (EPID) asociada.

Se han incluido en el estudio pacientes con AR (criterios de la ACR) y EPID asociada (documentada en las pruebas de función pulmonar y mediante CT-sean de alta resolución) (n=8) y voluntarios sanos fumadores (F) (n=6) y no fumadores (NF) (n=6).

Se analiza la producción, espontánea e inducida por lipo-polisacárido bacteriano (LPS), de TNF- α e IL-6 por los MA obtenidos mediante lavado broncoalveolar (LBA). Los MA, aislados mediante gradiente de centrifugación Ficoll-Hypaque y adherencia al plástico, fueron cultivados en medio completo (RPMI 1640 + 10% STF) en presencia y ausencia de LPS (100ng/ml). La producción de TNF-α e IL-6 fue medida en los sobrenadantes por ELISA.

Tanto la liberación espontánea como la inducida de TNF-α por los MA del grupo AR está significativamente incrementada en relación a controles (p<0,01). Los MA estimulados con LPS de pacientes con AR y EPID liberan también mayores cantidades de IL-6 que los de controles sanos. Tanto la producción espontánea como la inducida de IL-6 están significativamente reducidas en F en relación a NF.

El estudio de la secreción de TNF-α e IL-6 en el LBA de pacientes con AR y EPID refleja una hiperreactividad de los MA en estos pacientes, quizá presensibilizados como consecuencia del propio proceso inflamatorio pulmonar. Son necesarios nuevos estudios para definir el papel de estos mediadores en la patogenia del proceso.

Palabras clave:
Artritis reumatoide
Lavado broncoalveolar
TNF-α IL-6

The aim of this study was to measure the production of tumor necrosis factor-a (TNF-α) and interleukin-6 (IL-6) by alveolar macrophages in patients with rheumatoid arthritis and interstitial lung disease (ILD).

Rheumatoid arthritis patients diagnosed by ACR criteria (n=8) with associated ILD documented by pulmonary function tests and high resolution computerized tomography scanning, and 12 healthy volunteers (6 smokers and 6 nonsmokers).

We determined the spontaneous and induced production of bacterial lipopolysaccharides (LSP), TNF-α and IL-6 by alveolar macrophages obtained by bronchoalveolar lavage. The macrophages were isolated by Ficoll-Hypaque gradient centrifugation and plastic adherence and cultured in serumcontaining medium (low endotoxin) in the presence and absence of LPS (100ng/ml). TNF-α and IL-6 levels contents were determined in supernatants by ELISA.

In the patient group both spontaneous and induced production of TNF-α were significatly higher than in Controls (p<0.01). Macrophages stimulated with LPS in patients with rheumatoid arthritis and ILD also released greater amounts of IL-6 than did those of the healthy Controls. IL-6 spontaneous and induced production was significantly lower in smokers than in nonsmokers.

TNF-α and IL-6 production in patients with rheumatoid arthritis and ILD, studied in bronchoalveolar lavage specimens reveals that alveolar macrophages are hyperreactive in these patients, who are possibly sensitized as a consequence of the inflammatory lung process inherent to the disease. Further study is needed to define the pathogenic role of these mediators.

Key words:
Rheumatoid arthritis
Bronchoalveolar lavage
TNF-α IL-6
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Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
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