TY - JOUR T1 - Response to methotrexate in early rheumatoid arthritis is associated with a decrease of T cell derived tumour necrosis factor α, increase of interleukin 10, and predicted by the initial concentration of interleukin 4 JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 311 LP - 314 DO - 10.1136/ard.59.4.311 VL - 59 IS - 4 AU - Martin Rudwaleit AU - Zhinan Yin AU - Stephanie Siegert AU - Martina Grolms AU - Andreas Radbruch AU - Jürgen Braun AU - Joachim Sieper Y1 - 2000/04/01 UR - http://ard.bmj.com/content/59/4/311.abstract N2 - OBJECTIVE This study was performed to assess whether there is any change in the T cell cytokine pattern in early rheumatoid arthritis (RA) patients treated with methotrexate (MTX) and whether the lymphocytic cytokine pattern correlates with disease activity.METHODS Eight patients with RA (disease duration < six months) were studied serially before, after three, and after six to nine months of treatment with MTX for the cytokines tumour necrosis factor α (TNFα), interferon γ (IFNγ), interleukin 4 (IL4) and interleukin 10 (IL10) by intracellular staining of T cells derived from peripheral blood. Response to treatment was assessed by the modified disease activitiy score.RESULTS The clincial response was accompanied by a significant decrease of TNFα positive CD4+ T cells from a median of 8.53% (interquartile range 5.83–10.91%) before treatment to 6.17% (2.15–6.81%) after six to nine months of treatment (p=0.021). Inversely, IL10 positive T cells increased from a median of 0.65% (interquartile range 0.6–0.93%) to a median of 1.3% (1.22%-1.58%) after six to nine months of treatment (p=0.009). No significant change in the percentage of INFγ positive T cells and a small decrease of IL4 positive T cells during treatment were observed. The percentage of IL4 positive CD4+ T cells before treatment correlated with disease activity after six to nine months (r= −0.7066; p=0.05).CONCLUSIONS During treatment of RA with MTX the percentage of TNFα producing T cells decreases whereas that of IL10 producing T cells increases. This may affect macrophage activation and, therefore, may represent a regulatory mechanism relevant to disease remission. Furthermore, the percentage of IL4 positive CD4+ T cells at disease onset may be a useful prognostic marker. ER -