THE EFFECT OF METHOTREXATE AND AZATHIOPRINE ON THE SERUM LEVELS OF IGA-ALPHA(1)-ANTITRYPSIN COMPLEX IN JUVENILE CHRONIC ARTHRITIS

In the present study we investigated the influence of methotrexate (MT X) and azathioprine (AZA) on the serum levels of the IgA-alpha(1)-anti trypsin (IgA-AT) complex in patients with the systemic form of juvenil e chronic arthritis (JCA). Fifty-six JCA patients (22 treated with MTX , 18 treated with AZA, and 16 not treated with any immunosuppressive a gent) were enrolled in the study. MTX dosage ranged from 0.3 to 0.5 mg kg(-1) week(-1), while AZA was given daily at an average dose of 1 mg /kg. MTX was given for 13 months (SD = 7 months) whereas AZA for 11 mo nths (SD = 6 months). The average value of the complex was higher in J CA patients than in both control groups (0.74 +/- 0.73 U vs 0.37 +/- 0 .13 U (control children), P<0.001 and vs 0.23 +/- 0.12 U (control adul ts), P<0.001). Values exceeding the normal range were found in twenty- two JCA patients (39.4%). Serum IgA-AT level was lowest in the MTX gro up compared to AZA and non-treated patients (0.56 +/- 0.24 U, 0.76 +/- 0.43 U, 0.95 +/- 10.52 U, respectively, P<0.05). IgA values exceeding normal levels for age were found in 14% of the patients. A correlatio n between the levels of the IgA-AT complex and C-reactive protein (r = 0.43, P<0.01), alpha(1)-acid-glycoprotein (r = 0.45, P<0.01), alpha(1 )-antichymotrypsin (r = 0.52, P<0.01), alpha(1)-antitrypsin (r = 0.40, P<0.01) and IgA (r = 0.56, P<0.01) was established.