Leukapheresis in rheumatoid arthritis. Association of clinical improvement with reversal of anergy.
In order to study the clinical and immunologic effects of a brief course of leukapheresis, 14 patients with clinically similar rheumatoid arthritis were segregated into 2 subgroups. Group A (7 patients) had subnormal lymphocyte tritiated thymidine incorporation to soluble antigens. After a brief course of leukapheresis, 6 of these 7 patients demonstrated substantial clinical improvement associated with significantly enhanced lymphocyte tritiated thymidine incorporation to soluble antigens. In contrast, none of the 7 patients in group B (normal immune functions) demonstrated similar changes in articular indices or lymphocyte proliferation. Thus, clinical improvement induced in a subset of rheumatoid arthritis patients appears to reflect modulation of function, and not simply immunosuppression.
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D005260:Female; D006801:Humans; D007937:Leukapheresis; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D008934:Mitogens / Q000276:immunology; D009108:Mumps Vaccine / Q000276:immunology; D012882:Skin Tests; D013745:Tetanus Toxoid / Q000276:immunology; D013936:Thymidine / Q000378:metabolism; D014374:Tuberculin Test
D000911:Antibodies, Monoclonal; D008934:Mitogens; D009108:Mumps Vaccine; D013745:Tetanus Toxoid; D013936:Thymidine