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<art>
	<ui>ar2395</ui>
	<ji>ARJ</ji>
	<fm>
		<dochead>Editorial</dochead>
		<bibl>
			<title>
				<p>Role of interleukin-7 in degenerative and inflammatory joint diseases</p>
			</title>
			<aug>
				<au id="A1" ca="yes">
					<snm>van Roon</snm>
					<mi>AG</mi>
					<fnm>Joel</fnm>
					<insr iid="I1"/>
					<email>j.vanroon@umcutrecht.nl</email>
				</au>
				<au id="A2">
					<snm>Lafeber</snm>
					<mi>PJG</mi>
					<fnm>Floris</fnm>
					<insr iid="I1"/>
				</au>
			</aug>
			<insg>
				<ins id="I1">
					<p>Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Heidelberglaan, 3584 CX Utrecht, The Netherlands</p>
				</ins>
			</insg>
			<source>Arthritis Research &amp; Therapy</source>
			<issn>1478-6354</issn>
			<pubdate>2008</pubdate>
			<volume>10</volume>
			<issue>2</issue>
			<fpage>107</fpage>
			<url>http://arthritis-research.com/content/10/2/107</url>
			<note>See related research by Long <it>et al.</it>, <url>http://arthritis-research.com/content/10/1/R23</url></note>
			<xrefbib>
				<pubidlist><pubid idtype="pmpid">18466642</pubid><pubid idtype="doi">10.1186/ar2395</pubid>
				</pubidlist></xrefbib>
		</bibl>
		<history>
			<pub>
				<date>
					<day>18</day>
					<month>4</month>
					<year>2008</year>
				</date>
			</pub>
		</history>
		<cpyrt>
			<year>2008</year>
			<collab>BioMed Central Ltd</collab>
		</cpyrt>
		<abs>
			<sec>
				<st>
					<p>Abstract</p>
				</st>
				<p>IL-7 is known foremost for its immunostimulatory capacities, including potent T cell-dependent catabolic effects on bone. In joint diseases like rheumatoid arthritis and osteoarthritis, IL-7, via immune activation, can induce joint destruction. Now it has been demonstrated that increased IL-7 levels are produced by human articular chondrocytes of older individuals and osteoarthritis patients. IL-7 stimulates production of proteases by IL-7 receptor-expressing chondrocytes and enhances cartilage matrix degradation. This indicates that IL-7, indirectly via immune activation, but also by a direct action on cartilage, contributes to joint destruction in rheumatic diseases.</p>
			</sec>
		</abs>
	</fm>
	<bdy>
		<sec>
			<st>
				<p/>
			</st>
			<p>IL-7 is well-known for its strong immunostimulatory properties, in particular for the role it has in T and B cell homeostasis in mice and T cell homeostasis in humans. Less well-studied is the role of IL-7 in (immuno)pathology, in particular its role in joint diseases. In the previous issue of <it>Arthritis Research and Therapy</it>, Long and colleagues <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> demonstrate that IL-7 protein is produced by articular chondrocytes. Production is increased upon stimulation with fibronectin fragments and a combination of IL-1 and IL-6. Most interestingly, endogenous production of IL-7 by cartilage tissue is higher when obtained from older donors or from patients with osteoarthritis (OA). Through chondrocyte-expressed IL-7 receptor (IL-7R), this IL-7 is demonstrated to induce production of matrix metalloproteinase (MMP)-13 associated with enhanced release of proteoglycans from cartilage matrix. Thus, it has been suggested that IL-7 contributes in an autocrine manner to joint tissue destruction in OA and other joint diseases.</p>
			<p>In support of a role for IL-7 in OA, it was recently shown that in synovial tissue of a substantial proportion of OA patients, IL-7 is expressed at a significant level (albeit lower than in rheumatoid arthritis patients) <abbrgrp><abbr bid="B2">2</abbr></abbrgrp>. This IL-7 is considered to contribute to cartilage destruction indirectly through activation of inflammatory cells that secrete catabolic cartilage-destructive mediators, contributing to joint destruction. It has now been suggested that IL-7 is involved in cartilage destruction not only indirectly via inflammatory cells but also directly via IL-7R-expressing chondrocytes. However, although factors such as fibronectin fragment, and IL-1 and IL-6 induce IL-7, the (patho)physiological triggers for IL-7 production by human articular chondrocytes <it>in vivo </it>remain to be determined. Mechanical stress is one of the mechanisms that should be considered. Definitive proof should be provided by blockade of the IL-7/IL-7R pathway, limiting intrinsic degenerative cartilage destruction <it>in vitro </it>and <it>in vivo</it>, preferably in experimental models of degenerative joint damage that mimic OA but with minor inflammation <abbrgrp><abbr bid="B3">3</abbr></abbrgrp>. This is of particular importance since the amounts of IL-7 produced by chondrocytes in the experiments described by Long and colleagues are below the amounts needed to induce MMP-13 production and matrix degradation.</p>
			<p>Irrespective of this, the data from the study of Long and colleagues underline the role of IL-7 in the induction of joint pathology in rheumatic diseases. It was recently demonstrated that IL-7, apart from its role in T cell development in humans, can stimulate inflammatory T cells to produce tissue destructive cytokines that have a catabolic effect on cartilage and bone <abbrgrp><abbr bid="B4">4</abbr><abbr bid="B5">5</abbr><abbr bid="B6">6</abbr><abbr bid="B7">7</abbr></abbrgrp>. Together these studies suggest that IL-7 promotes joint destruction especially in patients that suffer from inflammatory (auto)immune diseases, many of which have increased IL-7 levels. Thus it was demonstrated that IL-7 induced T cell-dependent activation of monocytes/macrophages is associated, amongst other things, with tumour necrosis factor (TNF)&#945; production <abbrgrp><abbr bid="B6">6</abbr></abbrgrp>. Although it needs to be demonstrated that this results in joint damage in RA, the well-studied capacities of TNF&#945; in this respect strongly suggest that this will be the case. TNF&#945; is a potent inhibitor of cartilage matrix synthesis and an inducer of cartilage degradation (by activation of MMPs), processes that lead to loss of cartilage integrity. TNF&#945; also activates fibroblasts to produce catabolic factors such as cytokines and MMPs that indirectly facilitate cartilage destruction. IL-7 has also recently been shown to induce T cell-dependent osteoclast formation from monocytes. TNF&#945; and RANKL (receptor activator of nuclear factor kappa B ligand) are crucial mediators in this IL-7-driven osteoclast formation <abbrgrp><abbr bid="B7">7</abbr></abbrgrp>. Interestingly, in the study of Long and colleagues, TNF&#945; was not tested as an inducer of chondrocyte produced IL-7, nor did IL-7 stimulation lead to TNF&#945; production by chondrocytes. This suggests that the chondrocyte IL-7/IL-7R pathway is independent from and additive with a TNF&#945;-driven pathway. This is supported by recent findings demonstrating TNF&#945;-independent IL-7-driven inflammatory and bone-destructive activity <abbrgrp><abbr bid="B6">6</abbr><abbr bid="B7">7</abbr></abbrgrp>.</p>
			<p>IL-7 is also able to regulate joint pathology by T cell-driven immune activation in the absence of a clear inflammatory response. Experimental data have recently demonstrated the strong potential of IL-7 to facilitate bone loss. IL-7R-deficient mice display increased bone volume and bone density <abbrgrp><abbr bid="B8">8</abbr></abbrgrp>. In contrast, IL-7-overexpressing transgenic mice are characterized by expanded bone marrow cavities with focal osteolysis of cortical bone and eroded bone surfaces <abbrgrp><abbr bid="B9">9</abbr></abbrgrp>. In addition, estrogen deficient mice (induced by ovariectomy) are characterized by increased IL-7-driven T cell-dependent bone loss <abbrgrp><abbr bid="B10">10</abbr></abbrgrp>.</p>
			<p>By giving a first glimpse of the direct effects of IL-7 on chondrocytes, the study of Long and colleagues contributes to our knowledge on the broad range of IL-7/IL-7R-driven pathways. In addition to its role in inflammation driven joint destruction, and its potential role in T cell-driven bone loss in the absence of prominent inflammation, direct harmful effects on cartilage can be added to the list of catabolic properties of IL-7. In this respect, the IL-7/IL-7R-stimulated pathology is a target of interest for the treatment of rheumatic diseases such as rheumatoid arthritis, osteoporosis and OA.</p>
		</sec>
		<sec>
			<st>
				<p>Abbreviations</p>
			</st>
			<p>IL = interleukin; IL-R = IL receptor; MMP = matrix metalloproteinase; OA = osteoarthritis; TNF = tumour necrosis factor.</p>
		</sec>
		<sec>
			<st>
				<p>Competing interests</p>
			</st>
			<p>The authors declare that they have no competing interests.</p>
		</sec>
	</bdy>
	<bm>
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