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Table 1.

Clinical characteristics of RA patients in serum cohort.

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Figure 1.

ANGPTL4 is expressed by osteoclasts in RA.

(A) ANGPTL4 is strongly expressed by osteoclasts (arrows) in the RA synovium. Inset: Representative isotype control image. (B) Resorbing osteoclasts adjacent to bone (starred) express ANGPTL4. (C) ANGPTL4 (red) expression co-localises with cathepsin K-positive (green) osteoclasts. Representative images from n = 3 cases. (D) Cathepsin K-positive (green) osteoclasts in the OA synovium do not express detectable ANGPTL4 (red). All scale bars represent 100 µM.

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Figure 2.

HIF-1α is expressed by osteoclasts in RA.

(A) HIF-1α expression by osteoclasts in the RA synovium (arrows). Representative image from n = 3 cases. (B) HIF-1α (green) and ANGPTL4 (red) expression co-localises in 2 bone-apposing osteoclasts (arrows). All scale bars represent 100 µM. (C) ANGPTL4 (solid lines) and SLC2A1 (Glut-1; dashed lines) mRNA expression in monocyte-derived osteoclasts from RA patients following 24 h exposure to normoxia or hypoxia (2% O2). Hypoxic fold-change in mRNA expression; *, p<0.05.

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Figure 3.

ANGPTL4 and HIF-1α are expressed in RA synovial tissue.

(A) The RA synovium is strongly positive for ANGPTL4, as are adjacent blood vessels and surrounding stromal cells; (B) normal synovium shows weak, heterogeneous expression of ANGPTL4. (C) RA synovium is strongly positive for HIF-1α, as are adjacent blood vessels; (D) normal synovium generally does not express HIF-1α. (E) Synovial lining cells and stromal cells adjacent to lymphoid aggregates express ANGPTL4. Inset: ANGPTL4-positive plasma cells. (F) ANGPTL4 (red) is not expressed by B cells (CD20, green). (G) ANGPTL4 (red) is expressed by CD68-positive (green) macrophages adjacent to a lymphoid aggregate. (H) The OA synovium expresses elevated levels of both ANGPTL4 (left panel) and HIF-1α (right panel) compared with the normal synovium. Scale bars (A–F, H) represent 100 µM, scale bar (G) represents 50 µM.

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Figure 4.

Serum and synovial fluid ANGPTL4 concentrations are elevated in RA.

(A) Synovial fluid from RA patients contains more ANGPTL4 (203.3±264.8 ng/ml, range 68.7–847.3 ng/ml) than that from patients with non-inflammatory OA (64.4±13.6 ng/ml, range 50.4–82.2 ng/ml). *, p<0.05. (B) Serum from RA patients contains more ANGPTL4 (363.4±138.7 ng/ml, range 24.0–2235.0) than that from OA patients (39.0±3.4 ng/ml, range 11.9–100.5 ng/ml) or normal controls (45.8±6.7 ng/ml, range 6.5–154.7 ng/ml). **, p<0.01. (C) Serum from ‘high ANGPTL4’ RA patients is more likely to have detectable RANKL (black shading; RANKL-positive) than either serum from ‘low ANGPTL4’ RA patients or controls. White shading; RANKL-negative. *, p<0.05.

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