Pro-inflammatory role of serotonin and interleukin-6 in arthritis and spondyloarthropathies - measurement of disease activity by bone scan and effect of steroids

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Abstract
Objective: As serotonin is a mediator of inflammatory joint disease, serum levels were investigated in human patients with arthritis for a possible corresponding role as a disease marker. Design: 48 patients were evaluated by bone scan for disease activity. 5-HT and CRP were measured in the whole group, and IL-6 in those not yet receiving corticosteroids. The pro-inflammatory parameters were compared to each other and to scintigraphic features. Results: The serum levels of serotonin did not correspond to disease activity measured by CRP, IL-6 or activity on joints in skeletal scintigraphy. No difference was seen in comparison to the values of a control group, but when glucocorticoid treatment was included, low 5-HT serum values were observed. A significant correlation between CRP and IL-6 as indicators of inflammation and bone scan results versus CRP could be shown. Conclusion: The measurement of serum serotonin provides no relevant information about disease activity in synovial inflammation. For monitoring osteoarthritis and synovial inflammation, bone scan and laboratory determination of CRP and IL-6 together appear to present useful information about infestation in the disease process.