Summary
We evaluated the effect of a one-year treatment of low dose methotrexate (MTX) on class specific rheumatoid factors in 27 patients with rheumatoid arthritis (RA). Enzyme-linked immunosorbent assay (ELISA) showed after 6 and 12 months a significant reduction of IgM-RF, IgA-RF and IgF-RF levels from the baseline values. During MTX treatment, changes of each RF isotype were not correlated with any other isotype and its corresponding immunoglobulin changes. Moreover, immunological changes were not related to the improvement of clinical parameters. Our results showed that low dose MTX can specifically affect levels of RF isotypes, which are involved in the immune pathogenesis of RA.
Article PDF
Similar content being viewed by others
References
Gottlieb, N.L., Kiem, I.M., Penneys, N.S., Chultz, D.R. The influence of chrysotherapy on serum protein and immunoglobulin levels, rheumatoid factor and antiephitelial antibody titres. J Lab Clin Med 1975, 86, 962–972.
Lorber, A., Simon, T., Leeb, J., Peter, A., Wilcox, S. Chrysotherapy: suppression of immunoglobulin synthesis. Arthritis Rheum 1978, 21, 785–791.
Pritchard, M.H., Nuki, G. Gold and penicillamine: a proposed mode of action in rheumatoid arthritis, based on synovial fluid analysis. Ann Rheum Dis 1978, 37, 493–503.
Bluestone, R., Goldberg, L.S. Effect of D-penicillamine on serum immunoglobulins and rheumatoid factor. Ann Rheum Dis 1973, 32, 50–52.
Wernick, R., Merryman, P., Jaffe, I., Ziff, M. IgG and IgM rheumatoid factors in rheumatoid arthritis: quantitative response to D-penicillamine therapy and relationship to disease activity. Arthritis Rheum 1983, 26, 593–598.
Alarcon, G.S., Schrohenloher, R.E., Bartolucci, A.A., Ward, J.R., Williams, H.J., Koopman, W.J. Suppression of rheumatoid factor production by methotrexate in patients with rheumatoid arthritis. Arthritis Rheum 1990, 8, 1156–1161.
Andersen, P.A., West, S.G., O'Dell, J.R., Via, C.S., Claypool, R.G., Kotzin, B.L. Weekly pulse methotrexate in rheumatoid arthritis. Ann Int Med 1985, 103, 489–496.
Boerbooms, A.M.T., Seurissen, M.E.C., Westgeest, A.A.A., Theunisse, H., Van de Putte, L.B.A. Methotrexate in refractory rheumatoid arthritis. Clin Rheumatol 1988, 7, 249–256.
Cannon, G.W., Reading, J.C., Ward, J.R., Blonquist, L.J., Collette, L.B. Clinical and laboratory outcomes during the treatment of rheumatoid arthritis with methotrexate. Scand J Rheumatol 1990, 19, 285–294.
Hamdy, H., McKendry, R.J.R., Mierins, E., Liver, J.A. Low-dose methotrexate compared with azathioprine in the treatment of rheumatoid arthritis. Arthritis Rheum 1987, 30, 361–367.
Jeurissen, M.C., Boerbooms, A.M.T., Van de Putte, L.B. et al. Methotrexate versus azathioprine in the treatment of rheumatoid arthritis. Arthritis Rheum 1991, 34, 961–972.
Kremer, J.M., Lee, J.K. A long-term prospective study of the use of methotrexate in rheumatoid arthritis. Arthritis Rheum 1988, 31, 577–584.
Kremer, J.M., Phelps, C.T. Long term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis. Arthritis Rheum 1992, 35, 138–145.
Olsen, N.J., Callahan, L.F., Pincus, T. Immunologic studies of rheumatoid arthritis patients treated with methotrexate. Arthritis Rheum 1987, 30, 481–488.
Weinblatt, M.E., Trentham, D.E., Fraser, P.A. et al. Long term prospective trial of low dose methotrexate in rheumatoid arthritis. Arthritis Rheum 1988, 31, 167–175.
Williams, H.J., Willkens, R.F., Samuelson, C.O. et al. Comparison of low dose methotrexate and placebo in the treatment of rheumatoid arthritis. Arthritis Rheum 1985, 28, 721–730.
Arnett, F.C., Edworthy, S.M., Bloch, D.A. et al. The 1987 revised ARA criteria for classification of rheumatoid arthritis. Arthritis Rheum 1988, 31, 315–324.
Teitsson, I., Valdimarsson, H. Use of monoclonal antibodies and F(ab')2 enzyme conjugates in ELISA for IgM, IgA and IgG rheumatoid factors. J Immunol Meth 1984, 71, 149–161.
Bampton, J.L.M., Cawston, T.E., Kyle, M.V., Hazleman, B. Measurement of rheumatoid factors by an enzyme-linked immunosorbent assay (ELISA) and comparison with other methods. Ann Rheum Dis 1985, 44, 13–19.
Wernick, R., Lo Spalluto, J.J., Fink, C.W., Ziff, M. Serum IgG and IgM rheumatoid factors by solid phase radioimmunoassay. A comparison between adult and juvenile rheumatoid arthritis. Arthritis Rheum 1981, 12, 1501–1511.
Segal, R., Yaron, M., Tartakovsky, B. Methotrexate: mechanism of action in rheumatoid arthritis. Seminars in Arthritis Rheum 1990, 20, 190–199.
Kremer, J.M., Lee, J.K. The safety and efficacy of the use of methotrexate in long-term therapy for rheumatoid arthritis. Arthritis Rheum 1986, 29, 822–831.
Koopman, W.J., Schrohenloher, R.E., Czerkinsky, C. Differential expression of IgA and IgM rheumatoid factors in human disease: evidence for independent regulation of rheumatoid factors isotype production. In: Recent Advances in Mucosal Immunology. Part B: Effector Function. Eds.: McGhee, J., Mestecky, J., Ogra, P.L., Bienenstock, J. New York, Plenum 1987.
Winchester, R.J., Agnello, V., Kunkel, H.G. Gamma globulin complexes in synovial fluids of patients with rheumatoid arthritis. Partial characterization and relationship to lowered complement levels. Clin Exp Immunol 1970, 6, 689–706.
Mannik, M., Nardella, F.A. IgG Rheumatoid factors and self association of these antibodies. Clin Rheum Dis 1985, 11, 551–572.
Dorner, R.W., Alexander, R.L., Moore, T.L. Rheumatoid factors. Clinica Chim Acta 1987, 161, 1–21.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Spadaro, A., Riccieri, V., Sili Scavalli, A. et al. One year treatment with low dose methotrexate in rheumatoid arthritis: Effect on class specific rheumatoid factors. Clin Rheumatol 12, 357–360 (1993). https://doi.org/10.1007/BF02231579
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02231579