title: Changes in lymphocyte infiltration of the synovial membrane and the clinical course of rheumatoid arthritis.
abstract: Multiple samples of synovial membrane were obtained by needle biopsy from 24 patients with rheumatoid arthritis (RA) before, and 1 year after, standard antirheumatic drug therapy was given. Changes in the immunohistologic features of the synovial membrane (read blindly) were compared with the clinical course of RA in each patient. A composite clinical index of disease activity (IDA) and spontaneous in vitro synthesis of IgM rheumatoid factor (IgM-RF) by blood mononuclear cells were also measured before and after treatment. In 16 patients (group A), the IDA indicated 26-69% improvement, and the values for spontaneous IgM-RF decreased substantially. In 8 patients (group B), the IDA indicated deterioration or no improvement, and the values for spontaneous IgM-RF were unchanged. In group A patients, the intensity of the T cell infiltrate decreased from a mean score of 1.3 to a mean score of 0.8 (P = 0.025). The ratio of T helper cells to T suppressor/cytotoxic cells was greater than or equal to 2:1 in 90% of group A patients before treatment, compared with 20% of these patients after treatment (P = 0.016), and the number of biopsy samples that contained identifiable B cells decreased from 36% before treatment to 7% after treatment. In group B patients, there were no changes in the intensity of T cell infiltration, the ratio of T helper cells to T suppressor/cytotoxic cells, or the number of biopsy samples with identifiable B cells.
authors: University College Dublin, Department of Rheumatology, St. Vincent's Hospital, Ireland.
authors: M
authors: M
authors: Rooney
authors: A
authors: A
authors: Whelan
authors: C
authors: C
authors: Feighery
authors: B
authors: B
authors: Bresnihan
mesh_terms: D000911:Antibodies, Monoclonal; D001172:Arthritis, Rheumatoid / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis; D008214:Lymphocytes / Q000145:classification / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000096:biosynthesis; D012720:Severity of Illness Index; D013194:Staining and Labeling; D013583:Synovial Membrane / Q000473:pathology*
chemical_list: D000911:Antibodies, Monoclonal; D007075:Immunoglobulin M; D012217:Rheumatoid Factor