The cytotoxic T cell response to Epstein-Barr virus as measured by the regression assay was found to be impaired in a group of patients with active rheumatoid arthritis (RA). When these patients responded clinically to treatment with sulphasalazine there was a concomitant increase in the strength of this virus specific T cell response. The suggestion of a correlation between disease activity and impairment in this immune response was borne out in studies of other groups of patients with RA. Thus six out of 10 hospitalised patients had abnormal regression compared with six out of 31 patients seen routinely as outpatients. Studies of patients with inflammatory arthropathies other than RA, however, also showed abnormal regression in four out of 16 patients. It is concluded that the impairment in the cytotoxic T cell response to Epstein-Barr virus in RA is influenced by disease activity, and that this abnormality is not a specific feature of rheumatoid disease.
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