title: Decreased pokeweed mitogen-induced IgM and IgM rheumatoid factor synthesis in rheumatoid arthritis patients treated with gold sodium thiomalate or penicillamine.
abstract: Prospective and retrospective analysis of data obtained on 119 patients with rheumatoid arthritis suggested a relationship between clinical response induced by gold salts or D-penicillamine and decreased in vitro antibody synthesis by peripheral blood mononuclear cells. A subgroup of 21 patients with inactive disease receiving these drugs was found to have decreased pokeweed mitogen-induced in vitro synthesis of IgM and IgM rheumatoid factor. Detailed analysis of the cellular mechanisms responsible for this decreased responsiveness demonstrated markedly decreased B cell function. Patients treated with D-penicillamine also had altered T cell helper function manifested by incomplete reconstitution of the normal IgM response, while patients treated with gold salts had normal T cell function. Monocytes appeared not to have a major role in the decreased in vitro responsiveness. The results suggest that, in patients who respond to gold salts or D-penicillamine, antibody synthesis by circulating B cells is profoundly decreased, probably due to an indirect effect of these disease-modifying agents.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology*; D006052:Gold Sodium Thiomalate / Q000627:therapeutic use*; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis*; D066298:In Vitro Techniques; D010396:Penicillamine / Q000627:therapeutic use*; D011043:Pokeweed Mitogens / Q000494:pharmacology; D011446:Prospective Studies; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000096:biosynthesis*
chemical_list: D007075:Immunoglobulin M; D011043:Pokeweed Mitogens; D006052:Gold Sodium Thiomalate; D012217:Rheumatoid Factor; D010396:Penicillamine