Enhanced activity of NLRP3 inflammasome in peripheral blood cells of patients with active rheumatoid arthritis

Introduction: Interleukin-1 beta (IL-1 beta) is a major inflammatory cytokine, produced predominantly by innate immune cells through NLRP3-inflammasome activation. Both intrinsic and extrinsic danger signals may activate NLRP3. Genetic variations in NLRP3-inflammasome components have been reported to influence rheumatoid arthritis (RA) susceptibility and severity. We sought to assess the activity of NLRP3-inflammasome in patients with active RA compared to healthy individuals. Method: Intracellular protein expression of NLRP3, ASC, pro-and active caspase-1, pro-and active IL-1 beta was assessed by immunoblotting both at baseline and upon inflammasome activation. NLRP3 function (IL-1 beta secretion) was assessed upon priming of TLR2 (Pam(3)CysSK(4), TLR3 (poly(I:C)) or TLR4 (LPS) and ATP sequential treatment. We used caspase inhibitors (casp-1, 3/7 and 8) to assess their contribution to IL-1 beta maturation. All experiments were performed in whole blood cells. Results: Active RA patients (n = 11) expressed higher basal intracellular levels of NLRP3 (p < 0.008), ASC (p < 0.003), active caspase-1 (p < 0.02) and pro-IL-1 beta (p < 0.001). Upon priming with TLR4 (LPS) and ATP, RA-derived cell extracts (n = 7) displayed increased expression of NLRP3 (p < 0.01) and active caspase-1 (p < 0.001). Secreted IL-1 beta in culture supernatants from whole blood cells activated with TLR4 (LPS) or TLR3 agonist (poly(I: C)) plus ATP was higher in RA patients (n = 20) versus controls (n = 18) (p < 0.02 for both). Caspase-1 inhibition significantly reduced IL-1 beta secretion induced by all stimuli, whereas caspase-8 inhibition affected only TLR4 and TLR3 cell priming. Conclusion: Patients with active RA have increased expression of NLRP3 and NLRP3-mediated IL-1 beta secretion in whole blood cells upon stimulation via TLR3 and TLR4 but not TLR2. In these patients, IL-1 beta secretion seems to be predominately driven by caspase-1 and caspase-8. Targeting NLRP3 or downstream caspases may be of benefit in suppressing IL-1 beta production in RA.