British Journal of Rheumatology 1993;32:550-555 ASSOCIATION OF IN VITRO IMMUNE FUNCTIONS WITH THE SEVERITY OF THE DISEASE IN RHEUMATOID ARTHRITIS

Abstract

The production of immunoglobulins in vitro by lymphocytes from rheumatoid patients has been earlier shown to be defec-tive. This report describes a 2-year follow up study which shows that this defect is associated with the severity of RA. Poke-weed mitogen and Staphylococcus aureus Cowan I were used to stimulate in vitro immunoglobulin production by lymphocytes from patients with recent onset RA, and the relationshp of responses to clinical characteristics were studied. Impaired polyclonal IgM synthesis, already detectable at the onset of disease, associated with joint destructions observed after a 2-year follow up period. Further, phytohaemagglutinin-induced interleukin-2 (IL-2) release by the cells of patients with erosive disease was found to be reduced compared to cells from patients without eroded joints. The results indicate that altered immune functions—manifested as decreased production of IgM and IL-2—in RA are involved in the pro-gression of the disease and affect the outcome of patients and, thus, represent an unfavourable prognostic feature. KEY WORDS: Rheumatoid arthritis, In vitro Ig synthesis, Joint destruction, Interleukin-2, Association with unfavourable prognosis. RHEUMATOID arthritis (RA) is a chronic inflammatory disease in which hyper-responsiveness of the humoral immune system is evidenced by the production of rheu-matoid factors and the frequent occurrence of hyper

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