DECREASE IN PERIPHERAL-TYPE-1 OVER TYPE-2 T-CELL CYTOKINE PRODUCTION IN PATIENTS WITH RHEUMATOID-ARTHRITIS CORRELATES WITH AN INCREASE IN SEVERITY OF DISEASE

Objectives-To compare peripheral type 1 (T1) and type 2 (T2) T cell ac tivities in rheumatoid arthritis (RA) patients with that found for ost eoarthritic (OA) patients and healthy controls and to correlate periph eral T1/T2 cell activity in RA with parameters of the disease. Methods -Peripheral blood mononuclear cells were isolated from patients with R A (n=66), OA (n=19), and healthy controls (n=15). Primary T cell activ ity in these mononuclear cells was enhanced by means of anti-CD3/anti- CD28, which mimicks stimulation of T cells by activation of the T cell receptor and a major co-stimulatory signal. Interferon gamma (IFN gam ma) production and interleukin 4 (IL4) production in the three groups were quantified as measures of T1 and T2 cell activity, respectively, and compared. Serum tumour necrosis factor alpha (TNF alpha), erythroc yte sedimentation rate (ESR), C reactive protein (CRP), and joint dest ruction assessed radiographically of RA patients were determined as pa rameters of disease activity and correlated with T1/T2 cell activity. Results-Peripheral T cells from RA patients produced significantly les s IFN gamma and more IL4 than T cells from both age and sex matched OA patients and healthy controls. Moreover, in RA. patients both a decre ase in IFN gamma and an increase in IL4 production correlated with an increase in serum TNF alpha, ESR, CRP, and joint destruction. Conclusi ons-These results suggest a role for differential T cell activity in R A. In view of the intra-articular T1 cell predominance the results mig ht be explained by selective T1 cell migration into the joint or perip heral suppression of T1 cell activity.