Cyclic Nucleotides in Joint Fluid in Rheumatoid Arthritis and in Reiter's Syndrome

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Abstract
Levels of cyclic[c]AMP and cGMP were studied in joint in inflammatory arthropathies. A disturbed balance between cAMP and cGMP due to a depressed level of cAMP was found in rheumatoid arthritis (RA) and Reiter''s syndrome, in comparison with patients with osteoarthritis. No correlation could be seen between the absolute levels of cAMP or cGMP and the degree of local inflammatory activity, white cell count or lysosomal enzyme activity in the joint fluid. Intra-articular injection of epinephrine showed as good an effect on local pain as betamethasone (Celestona), but the steroid reduced the swelling more effectively. An increase in intracellular levels of cAMP at 20 min was seen after injection of epinephrine with a slight change in cGMP. Intra-articular injection of dibutyryl-cAMP (db-cAMP) produced a marked easing of local pain and swelling in each of the 4 patients treated. Apparently stimulation of the .beta.-adrenergic system or injection with db-cAMP may be beneficial in rheumatoid inflammation.