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Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly ( P    0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores ( r  = 0.92,  P &lt; 0.001 and  r  = 0.85,  P  &lt; 0.001), tender joint counts ( r  = 0.83,  P  &lt; 0.001 and  r  = 0.82,  P  &lt; 0.001 ), swollen joint counts ( r  = 0.72,  P  &lt; 0.001 and  r  = 0.60,  P  &lt; 0.001), visual analog scale ( r  = 0.82,  P  &lt; 0.001 and  r  = 0.82,  P  &lt; 0.001), erythrocyte sedimentation rate ( r  = 0.75,  P  &lt; 0.001 and  r  = 0.65,  P  &lt; 0.001), and C-reactive protein ( r  = 0.93,  P  &lt; 0.001 and  r  = 0.79,  P  &lt; 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?