Adlard, Nichola Jayne (2016). Expression of chemokines CXCL4 and CXCL7 in the synovium at an early stage of rheumatoid arthritis. University of Birmingham. Ph.D.
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Adlard16PhD.pdf
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Abstract
Identification of suitable biomarkers is growing increasingly important for the treatment of rheumatoid arthritis (RA). They can be measured in a number of different biological materials and can provide clinical information regarding prediction, diagnosis, and prognosis of disease, as well as response to therapeutics.
In this thesis, I utilised synovial biopsies collected from patients enrolled in the Birmingham Early Inflammatory Arthritis Cohort (BEACON) to test the hypothesis that detection of expression of CXCL4 and CXCL 7 may be used to predict progression of early stage synovitis to RA. I found that these two chemokines, CXCL4 and CXCL 7, were predominantly expressed on macrophages within the synovium of patients presenting with early synovitis. Increased CXCL4 and CXCL 7 was observed in patients with early RA compared to those with a resolving disease course. However, this increase was transient as expression in treatment naive established RA patients (>12 weeks duration, <3 years duration) was comparable
to uninflamed controls.
Moreover, I identified expression of a variant ofCXCL4, CXCL4Ll in the rheumatoid synovium. Expression of this potent inhibitor of angiogenesis was evident in the lining layer of the synovium.
These data highlight CXCL4 and CXCL 7 as potential predictors of disease outcome in patients presenting with early synovitis.
Type of Work: | Thesis (Doctorates > Ph.D.) | |||||||||
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Award Type: | Doctorates > Ph.D. | |||||||||
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College/Faculty: | Colleges (2008 onwards) > College of Medical & Dental Sciences | |||||||||
School or Department: | School of Immunity and Infection | |||||||||
Funders: | Versus Arthritis | |||||||||
Subjects: | R Medicine > RC Internal medicine | |||||||||
URI: | http://etheses.bham.ac.uk/id/eprint/6600 |
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