Research article

Raloxifene reduces urokinase-type plasminogen activator-dependent proliferation of synoviocytes from patients with rheumatoid arthritis

S Guiducci¹ , A Del Rosso¹, M Cinelli¹, F Perfetto¹, R Livi¹, A Rossi⁵, A Gabrielli³, R Giacomelli⁴, N Iori⁵, G Fibbi², M Del Rosso² and M Matucci Cerinic¹

¹  Department of Internal Medicine, Division of Rheumatology, University of Florence, Florence, Italy

²  Department of Experimental Pathology and Oncology, University of Florence, Florence, Italy

³  Institute of Clinical Medicine, Hematology and Clinical Immunology, University of Ancona, Didactic pole, Torrette di Ancona, Ancona, Italy

⁴  Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila, Italy

⁵  Medical Direction, Eli Lilly Italia S.p.a., Sesto Fiorentino (FI), Italy

author email corresponding author email

Arthritis Research & Therapy 2005, 7:R1244-R1253doi:10.1186/ar1815

Published:	8 September 2005

Abstract

Extracellular fibrinolysis, controlled by the membrane-bound fibrinolytic system, is involved in cartilage damage and rheumatoid arthritis (RA) synovitis. Estrogen status and metabolism seem to be impaired in RA, and synoviocytes show receptors for estrogens. Our aims in this study were to evaluate in healthy and RA synoviocytes the effects of Raloxifene (RAL), a selective estrogen receptor modulator (SERM), on: proliferation; the components of the fibrinolytic system; and chemoinvasion. The effects of RAL were studied in vitro on synoviocytes from four RA patients and four controls. Proliferation was evaluated as cell number increase, and synoviocytes were treated with 0.5 μM and 1 μM RAL with and without urokinase-plasminogen activator (u-PA) and anti-u-PA/anti-u-PA receptor (u-PAR) antibodies. Fibrinolytic system components (u-PA, u-PAR and plasminogen activator inhibitor (PAI)-1) were assayed by ELISA with cells treated with 0.5 μM and 1 μM RAL for 48 h. u-PA activity was evaluated by zymography and a direct fibrinolytic assay. U-PAR/cell and its saturation were studied by radioiodination of u-PA and a u-PA binding assay. Chemoinvasion was measured using the Boyden chamber invasion assay. u-PA induced proliferation of RA synoviocytes was blocked by RAL (p < 0.05) and antagonized by antibodies alone. The inhibitory effect of RAL was not additive with u-PA/u-PAR antagonism. RA synoviocytes treated with RAL showed, compared to basal, higher levels of PAI-1 (10.75 ± 0.26 versus 5.5 ± 0.1 μg/10⁶ cells, respectively; p < 0.01), lower levels of u-PA (1.04 ± 0.05 versus 3.1 ± 0.4 ng/10⁶ cells, respectively; p < 0.001), and lower levels of u-PAR (11.28 ± 0.22 versus 23.6 ± 0.1 ng/10⁶ cells, respectively; p < 0.001). RAL also significantly inhibited u-PA-induced migration. Similar effects were also shown, at least partially, in controls. RAL exerts anti-proliferative and anti-invasive effects on synoviocytes, mainly modulating u-PAR and, to a lesser extent, u-PA and PAI-1 levels, and inhibiting cell migration and proliferation.