BLOOD POLYMORPHONUCLEAR LEUKOCYTE MIGRATORY ACTIVITIES DURING RHEUMATOID-ARTHRITIS

Blood polymorphonuclear leukocyte (PMN) migratory activity was investi gated in adult rheumatoid arthritis (RA) patients and in healthy contr ol subjects using fresh whole blood in a novel membrane filter assay. The PMNs migrated under FMLP stimulation and under blank control condi tions (spontaneous migration). Essential evaluation criteria were the percentage of PMNs that migrated from the entire blood sample into the filters (TMI) and the penetration depth of the migrating cell bulk in to the filters (DC). PMNs from healthy subjects penetrate deeper under FMLP stimulation than under blank control conditions. Migration depen ds on age and sex: the TMI decreases, while the DC and the reactivity towards FMLP increase with age. FMLP triggers a stronger DC reaction i n females than in males. Compared with healthy subjects, patients with RA develop an increased PMN reaction, whereas FMLP inhibits migration in comparison with the blank controls. There is no correlation betwee n disease activity estimated by joint functions and PMN migratory acti vity, while there are strong correlations between disease activity and the classical RA laboratory parameters WBC, platelets, BSR, CRP, hemo globin and rheumatoid factor. PMNs therefore probably do not play a ma jor role in joint injury. Gold therapy inhibits DC reactivity. PMN mig ration in RA differs markedly from the reactions in juvenile rheumatoi d arthritis, where high disease activity is associated with high PMN m igratory activity, and the correlations between classical laboratory p arameters and disease activity follow other patterns than in RA.