Extracorporeal irradiation of thoracic duct lymph as immunosuppressive treatment in rheumatoid arthritis.
Thoracic duct drainage and re-infusion of the irradiated lymph was carried out as immunosuppressive treatment in 2 patients with progressive, therapy-resistant rheumatoid arthritis. In both patients, a marked clinical improvement was achieved even during the first days of treatment. A reduced number of T cells in the blood was seen 3 days after onset of drainage, whereas no significant change in the number of B cells was observed. No recirculation of the infused cells could be detected, nor was the radiation removal of T cells accompanied by rapid proliferation of "new" T cells. As clinical improvement and reduction in T cells occurred simultaneously, there is probably a connection between these two events. The beneficial clinical response and the achievement of T cell suppression by thoracic duct drainage--the result of irradiation and re-infusion of irradiated lymph--encourage further clinical trials with this type of treatment in severe therapy-resistant rheumatoid arthritis.
D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000628:therapy*; D001402:B-Lymphocytes / Q000276:immunology / Q000528:radiation effects; D002455:Cell Division / Q000528:radiation effects; D004322:Drainage; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007958:Leukocyte Count; D008196:Lymph / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D011830:Radiation Effects; D013601:T-Lymphocytes / Q000276:immunology / Q000528:radiation effects; D013897:Thoracic Duct / Q000601:surgery