EFFECTS OF BROMOCRIPTINE IN PATIENTS WITH ACTIVE RHEUMATOID-ARTHRITIS

Background: Neuroendocrine factors play an important role in the expre ssion of autoimmune diseases. Prolactin (PRL) can induce T-cell prolif eration and macrophage activation. Elevated PRL levels have been descr ibed in patients with rheumatoid arthritis (RA). Aim and Methods: We s tudied immunological and clinical effects of PRL suppression in 9 RA p atients with active disease, treated for 3 months with bromocriptine ( BRC), an inhibitor of PRL secretion. Results: BRC induced a significan t depression of the peripheral blood mononuclear cells response to ant igen (p=0.008) and mitogen (p=0.008) which was significantly correlate d with improvement in the HAQ disability index (r=0.68; p=0.04) and gr ip strength (r=0.7; p=0.02). Also, the in-vitro production of IL-2, ni tric oxide and poliamines-that are critical for the proliferative resp onse of lymphoid cells- decreased significantly. The group experienced significant improvement of grip strength (p=0.028) and the HAQ disabi lity index (p=0.025), whereas 4 individuals achieved clinical improvem ent according to the American College of Rheumatology preliminary defi nition. We conclude that BRC treatment induces a significant depressio n of in-vitro immune function in RA patients and that these changes ar e related to parameters of disease activity. The effects of BRC on imm une function and disease activity in RA patients warrant further inves tigation.