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a The
Medical Research Centre, Nottingham University, Nottingham City
Hospital NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, b School of
Human Development, Nottingham University
Correspondence to: Mr Crocker Email: Ian.Crocker{at}nottingham.ac.uk
Accepted for publication 31 January 2000
BACKGROUND
Pregnancy
exerts suppressive effects on rheumatoid arthritis (RA). An attenuation
in neutrophil function in late pregnancy which may explain this
amelioration has previously been reported.
OBJECTIVEA
longitudinal investigation of neutrophil activity in healthy pregnant
women (n=9) and pregnant patients with RA (n=9), compared with age
matched non-pregnant patients with RA (n=12) and healthy controls
(n=22).
METHODSNeutrophil
activation was measured in response to the physiological receptor
agonists, n-formyl-methionyl-leucyl-phenylalanine (fMLP) and zymosan
activated serum (ZAS). Superoxide anion production (respiratory burst)
was determined by lucigenin enhanced chemiluminescence (LUCL);
secondary granule lactoferrin release by enzyme linked immunosorbent assay (ELISA); and CD11b, CD18, and CD62L expression by flow cytometric analysis.
RESULTSStimulated
neutrophil LUCL was significantly reduced in both pregnant women with
RA and healthy pregnant women in the second (fMLP 43% and 69%, ZAS
43% and 59%, respectively) and third trimesters (fMLP 24% and 44%,
ZAS 32% and 38%, respectively). Responses returned to normal within
eight weeks of delivery and unstimulated levels remained unchanged
throughout pregnancy. Basal and stimulated CD11b, CD18, and CD62L
expression showed no variations throughout gestation for both pregnancy
groups. Likewise, stimulated lactoferrin release and plasma lactoferrin
remained unchanged. Certain morphological differences in RA neutrophils
were highlighted by the flow cytometric analysis. Moreover, resting
neutrophils and stimulated cells from patients with RA, including
pregnant subjects, showed a marked increase in LUCL, but a reduction in
CD11b, CD18, and CD62L. Low dose prednisolone and methylprednisolone
had no effect on neutrophil parameters over the period of treatment
with non-steroidal anti-inflammatory drugs.
CONCLUSIONThe
attenuation to neutrophil respiratory burst in both healthy and RA
pregnancies may offer an explanation for the pregnancy induced
remission of this inflammatory disorder.
This article has been cited by other articles:
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  T. Haupl, M. Ostensen, A. Grutzkau, G.-R. Burmester, and P. M. Villiger Interaction between rheumatoid arthritis and pregnancy: correlation of molecular data with clinical disease activity measures Rheumatology, June 1, 2008; 47(suppl_3): iii19 - iii22. [Abstract] [Full Text] [PDF]
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 H. R. Petty, A. L. Kindzelskii, J. Espinoza, and R. Romero Trophoblast contact deactivates human neutrophils. J. Immunol., March 1, 2006; 176(5): 3205 - 3214. [Abstract] [Full Text] [PDF]
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 I Crocker, N Lawson, and J Fletcher Effect of pregnancy and obstructive jaundice on inflammatory diseases: the work of P S Hench revisited Ann Rheum Dis, April 1, 2002; 61(4): 307 - 310. [Abstract] [Full Text] [PDF]
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 I.P. Crocker, N. Lawson, P.N. Baker, and J. Fletcher The anti-inflammatory effects of circulating fatty acids in obstructive jaundice: similarities with pregnancy-induced immunosuppression QJM, September 1, 2001; 94(9): 475 - 484. [Abstract] [Full Text] [PDF]
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