AUTOREACTIVITY TO HUMAN HEAT-SHOCK PROTEIN-60 PREDICTS DISEASE REMISSION IN OLIGOARTICULAR JUVENILE RHEUMATOID-ARTHRITIS

Objective. To determine whether T lymphocyte reactivity to endogenous human hsp60 plays a regulatory role in the course of oligoarticular ju venile rheumatoid arthritis (JRA). Methods. A prospective, longitudina l study of T cell reactivity to HSP in 15 patients with newly diagnose d HLA-B27 negative oligoarticular JRA was performed, Results were comp ared with those in a group of 20 patients with newly diagnosed polyart icular or systemic JRA. or with acute arthritis caused by other system ic diseases or viral infections, as well as with those in a group of 9 healthy control subjects. Results. In 86% of the patients with oligoa rticular JRA (13 of 15), significant T lymphocyte proliferative respon ses to hsp60 were found in peripheral blood mononuclear cells and/or s ynovial fluid mononuclear cells within 3 months after the onset of art hritis. Only 5% of the patients in the rheumatologic disease control g roup (1 of 20) showed such positivity, All patients with oligoarticula r JRA and positive responses to human hsp60 developed a remission of t heir disease within 12 weeks, During this period of remission, blood s amples were taken from 8 patients and showed significantly lower and e ven negative responses to hsp60, compared with active disease, when al l 8 patients had good responses. Conclusion. The results show that sig nificant proliferative responses to human hsp60 can be found early in the course of oligoarticular JRA, Furthermore, these responses correla te with disease activity in such a manner that T cell reactivity to hu man hsp60 seems to be associated with disease remission.