Effect of drug therapy on circulating and synovial fluid Ig-secreting cells in rheumatoid arthritis.
A common immunological abnormality in rheumatoid arthritis (RA) is an increased spontaneous polyclonal B cell activation. In order to study the influence of drug therapy in RA on the functional activity of B cells we enumerated spontaneous plaque-forming cells (PFC) in peripheral blood lymphocytes (PBL) and synovial fluid lymphocytes (SFL) by a reverse haemolytic plaque assay. Spontaneous IgG-, IgM-, and IgA-PFC in PBL of 26 patients with classical erosive RA receiving either gold salts or D-penicillamine were similar to those observed in 20 healthy controls. In contrast, significantly higher numbers of IgG- and IgA-PFC, but not IgM-PFC, were found in PBL of nine patients with classical erosive RA receiving non-steroidal anti-inflammatory drugs (NSAID) alone. Furthermore, spontaneous PFC in SFL from 16 consecutive patients with RA receiving second-line drugs, as well as 17 patients with other forms of arthritis (non-RA) were generally low and significantly less than those observed in 20 RA patients on NSAID alone. Moreover, a wide individual variation in PFC, especially in relation to the IgG class, was recorded in the synovial lymphocytes. These studies imply that treatment with second-line drugs is associated with normalisation of B cell activity in RA patients, and that the effect can be detected at the cellular level both in blood and synovial fluid.
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000921:Antibody-Producing Cells / Q000187:drug effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006046:Gold / Q000627:therapeutic use; D006462:Hemolytic Plaque Technique; D006801:Humans; D007070:Immunoglobulin A / Q000096:biosynthesis; D007074:Immunoglobulin G / Q000096:biosynthesis; D007075:Immunoglobulin M / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D013582:Synovial Fluid / Q000187:drug effects / Q000276:immunology
D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D006046:Gold; D010396:Penicillamine