RESUMEN
OBJECTIVE: To investigate the spontaneous cytokine gene expression in fibroblasts from patients with diffuse cutaneous systemic sclerosis. Their pattern of expression was correlated with the production of collagen. METHODS: Fibroblasts were obtained from skin biopsies of nine patients diagnosed with systemic sclerosis (mean 16 +/- 8.7 years of disease duration) and ten control individuals. The cytokine gene expression was detected by coupled reverse transcriptase polymerase chain reaction for interleukins 1 beta, 6, 8, tumour necrosis factor-alpha, and transforming growth factor beta. In addition, collagen synthesis was measured by [14C]-proline uptake in fibroblast cultures. RESULTS: All fibroblast samples from patients expressed the interleukin-6 gene (p = 0.04 compared with controls). Eight of the nine patients expressed interleukin-8 (p = 0.02 compared with controls). Four of them expressed also transforming growth factor beta and two more weakly expressed the tumour necrosis factor-alpha gene. Only one patient showed transcription for the interleukin-1 beta gene. In accordance with such immune activation, collagen synthesis was higher in fibroblasts from patients with systemic sclerosis (p = 0.028) as compared with normal controls. Indeed, a positive correlation was found between the expression of IL-6 gene and collagen production (rs = 1). CONCLUSION: The constitutive expression of IL-6 and IL-8 genes by fibroblasts may play an important role in the perpetuation of local immune dysregulation, thus leading to a permanent fibroblast activation in patients with systemic sclerosis.