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Ann Rheum Dis 1997;56:656-660 doi:10.1136/ard.56.11.656
  • Extended reports

Decrease in peripheral type 1 over type 2 T cell cytokine production in patients with rheumatoid arthritis correlates with an increase in severity of disease

  1. Joel A G van Roona,
  2. Catherina M Verhoefa,
  3. Johanna L A M van Roya,
  4. Frits H J Gmelig-Meylingb,
  5. Olga Huber-Bruninga,
  6. Floris P J G Lafebera,
  7. Johannes W J Bijlsmaa
  1. aDepartments of Rheumatology and Clinical Immunology, band Immunology, cUniversity Hospital Utrecht, P O Box 85500, 3508 GA Utrecht, the Netherlands
  1. Dr J A G van Roon, Department of Rheumatology and Clinical Immunology (F02.223), University Hospital Utrecht, P O Box 85500, 3508 GA Utrecht, the Netherlands.
  • Accepted 2 September 1997

Abstract

Objectives—To compare peripheral type 1 (T1) and type 2 (T2) T cell activities in rheumatoid arthritis (RA) patients with that found for osteoarthritic (OA) patients and healthy controls and to correlate peripheral T1/T2 cell activity in RA with parameters of the disease.

METHODS Peripheral blood mononuclear cells were isolated from patients with RA (n=66), OA (n=19), and healthy controls (n=15). Primary T cell activity in these mononuclear cells was enhanced by means of anti-CD3/anti-CD28, which mimicks stimulation of T cells by activation of the T cell receptor and a major co-stimulatory signal. Interferon gamma (IFNγ) production and interleukin 4 (IL4) production in the three groups were quantified as measures of T1 and T2 cell activity, respectively, and compared. Serum tumour necrosis factor α (TNFα), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and joint destruction assessed radiographically of RA patients were determined as parameters of disease activity and correlated with T1/T2 cell activity.

RESULTS Peripheral T cells from RA patients produced significantly less IFNγ and more IL4 than T cells from both age and sex matched OA patients and healthy controls. Moreover, in RA patients both a decrease in IFNγ and an increase in IL4 production correlated with an increase in serum TNFα, ESR, CRP, and joint destruction.

Conclusions—These results suggest a role for differential T cell activity in RA. In view of the intra-articular T1 cell predominance the results might be explained by selective T1 cell migration into the joint or peripheral suppression of T1 cell activity.

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