LYMPHOCYTES FROM SITE OF DISEASE INDICATE PROBABLE MICROBIOLOGICAL ETIOLOGY OF INFECTIVE-IMMUNE DISEASES SUCH AS RHEUMATOID-ARTHRITIS

Synovial lymphocytes, from the site of disease, by their response to m icrobiological antigen stimulation as measured by the [H-3]thymidine u ptake method, indicate the microbiological causes of reactive arthriti s and also oligoarthritis unassociated with enteric or genital symptom s. In the study of the etiology and pathogenesis of rheumatoid arthrit is, the application of the same procedures gives an indication that th e disease is an immune response to a variety of common infective agent s, both viral and bacterial. The demonstration of antigens or nucleic acid of an infective agent al the site of disease, in association with a specific local immune response suggests the pathogenetic importance of the agent. Recent studies of relationships between epitopes of inf ective agents and MHC gene products suggest several ways in which infe ctive agents can directly cause a disease such as rheumatoid arthritis without any requirement for autoimmune contributions. Because the inf ective agent may be the primary determining factor and the one most am enable to correction or eradication, the term ''infective-immune'' is suggested in preference to ''autoimmune'' for these immune-mediated di seases.