There have been some publications on adipokines at the ACR 2015 Annual Meeting in San Francisco, but I’ll restrict myself to the two studies related to rheumatoid arthritis.
Adipokines are cytokines and hormones, which are primarily synthesized in white adipose tissue. Some adipokines have already been identified to be associated with bad outcomes in rheumatoid arthritis. Lean people with a normal metabolic function produce anti-inflammatory adipokines, whereas obese people with mild metabolic dysfunction produce anti- and pro-inflammatory adipokines. Obese people with marked metabolic dysfunction produce pro-inflammatory cytokines etc. like TNF-alpha, IL-6, CCL2, CXCL5, leptin, resistin, to name a few.
Adrian Levitsky and colleagues presented: “Adipokines and Insulin-like Growth Factor 1 As Predictors of Clinical and Radiographic Outcomes in Early Rheumatoid Arthritis”. The authors looked at serum levels of adiponectin, leptin, IGF-1, and resistin of patients enrolled in the SWEFOT trial. Conclusion: “Differences in certain adipokines and IGF-1 were associated with clinical and radiographic outcomes within specific treatment groups. Thus, they may be useful predictors and may give insight into pathogenic mechanisms influencing RA outcomes such as high BMI and disease activity.” Please have a look at the charts yourself and you might agree that the first sentence of conclusion is correct, but the rest is speculation. Right now we can’t identify radiographic progressors by adipokines at baseline. But “may be in the future” is strong enough to wish the authors and other teams good luck and persistence.
Rebecca Hasseli and colleagues looked at: “The Influence of Adipokines on the Interaction of Rheumatoid Arthritis Synovial Fibroblasts with Endothelial Cells”. Methods: “Primary RASF [rheumatoid arthritis synovial fibroblasts] and EC [endothelial cells] were stimulated with adiponectin (10 µg/ml), visfatin (100 ng/ml) and resistin (20 ng/ml) as well as with MTX (1.5 µM) and the glucocorticoids prednisolone (1 µM) and dexamethasone (1 µM). […]”Conclusion: „Adipokines have an influence on the cellular expression of adhesion molecules on RASF and EC as well as their interaction. Adipokines increase adhesion of RASF to EC and therefore influence RASF migration. Therapeutics such as glucocorticoids and MTX antagonized these effects, which may represent a mechanism of the protective effects of these drugs observed in patients. […]”
What can we take out of these studies? Knowledge on adipokines will certainly influence our approach to rheumatoid arthritis in the future. I’d like to suggest more effort in psoriatic arthritis and adipokines as in this group of patients the level of metabolic dysfunction is especially high.
Levitsky A, Brismar K, Saevarsdottir S, Hambardzumyan K, Andersson A, van Vollenhoven RF. Adipokines and Insulin-like Growth Factor 1 As Predictors of Clinical and Radiographic Outcomes in Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/adipokines-and-insulin-like-growth-factor-1-as-predictors-of-clinical-and-radiographic-outcomes-in-early-rheumatoid-arthritis/. Accessed December 5, 2015.
Hasseli R, Frommer KW, Umscheid T, Schönburg M, Rehart S, Müller-Ladner U, Neumann E. The Influence of Adipokines on the Interaction of Rheumatoid Arthritis Synovial Fibroblasts with Endothelial Cells [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/the-influence-of-adipokines-on-the-interaction-of-rheumatoid-arthritis-synovial-fibroblasts-with-endothelial-cells/. Accessed December 5, 2015.
Chialà A, Rotondo C, Anelli MG, Praino E, Cantarini L, Scioscia C, Giannini M, Lapadula G, Iannone F. Evaluation of Serum Levels of Adipokines and Interleukines in Pericardial Effusion Related to Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/evaluation-of-serum-levels-of-adipokines-and-interleukines-in-pericardial-effusion-related-to-systemic-sclerosis/. Accessed December 5, 2015.
Korman B, Goncalves Marangoni R, Hinchcliff ME, Shah S, Carns MA, Ramsey-Goldman R, Varga J. Association of Serum Adipokines Adipsin, Adiponectin, and Leptin/Adiponectin Ratio with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/association-of-serum-adipokines-adipsin-adiponectin-and-leptinadiponectin-ratio-with-systemic-sclerosis/. Accessed December 5, 2015.
Ferreira da Silva T, Levy Neto M, Caparbo V, Takayama L, Pereira RMR. Abnormal Body Composition in Takayasu Arteritis Patients: Role of Inflammatory Cytokines and Adipokines [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/abnormal-body-composition-in-takayasu-arteritis-patients-role-of-inflammatory-cytokines-and-adipokines/. Accessed December 5, 2015.