Abstract:Objective To investigate the role of exosomes derived from fibroblast-like synoviocytes from patients with rheumatoid arthritis(RA-FLS) in macrophage(M) polarization. Methods Synovial fluid and tissue from osteoarthritis(OA) patients(n=6) and rheumatoid arthritis(RA) patients(n=6)were collected, and the cytokines in joint fluid were detected using flow cytometry bead array(CBA) method. The expression of extracellular marker CD9 in the synovium was detected with immunohi-stochemical method. Primary synovial RA-FLS and OA-FLS were isolated, and the exosomes from cell-culture supernatant were identified by Western blotting and nanoparticle tracking analysis(NTA). The effects of OA-FLS and RA-FLS exosomes on the M1 and M2 phenotype genes were determined with real time fluorescence quantitative PCR(qRT-PCR)and CBA. Results The expressions of M1 type markers(IL-1β, IL-6, IL-8), and M2 type marker(IL-10) in RA joint fluid were significantly higher than those in the OA group. High expression of CD9 was detected in RA synovium. RA-FLS was found to secrete more exosomes than OA-FLS. Elevated gene and protein expression levels of M1 markers were found in M treated with RA-FLS derived exosomes. Conclusion RA-FLS derived exosomes can induce M1 polarization in vitro.