title: Nonsteroidal anti-inflammatory drugs and immunologic function. Overview of the European experience.
abstract: A large number of nonsteroidal anti-inflammatory drugs are available in Europe. There appears to be little difference in overall clinical effectiveness of these drugs, despite individual patient variation, suggesting a common mode of action. Occasionally, a nonsteroidal anti-inflammatory drug will show some evidence of a more impressive anti-rheumatic effect, perhaps related to a more prolonged or different mode of action. The evidence for an immunologic effect of nonsteroidal anti-inflammatory drugs is largely derived from in vitro studies. In patients with rheumatoid arthritis treated with piroxicam, there are no overall changes in lymphocyte numbers or T4/T8 ratios, but numbers of activated cells expressing la decrease and rheumatoid factor titers may also fall. It is suggested that this is not a direct immunosuppressive effect, but one that is related to local inhibition of polymorphonuclear leukocyte-derived free radical production within the joint, which may lower the antigenic load of IgG altered by free radicals, with subsequent diminished immune stimulation.
mesh_terms: D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D066298:In Vitro Techniques; D007375:Interleukin-1 / Q000037:antagonists & inhibitors; D008214:Lymphocytes / Q000187:drug effects; D010894:Piroxicam; D011458:Prostaglandins E / Q000037:antagonists & inhibitors; D013583:Synovial Membrane / Q000166:cytology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D013843:Thiazines / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000949:Histocompatibility Antigens Class II; D007375:Interleukin-1; D011458:Prostaglandins E; D013843:Thiazines; D010894:Piroxicam