In vivo T cell depletion in rheumatoid arthritis is associated with increased in vitro IgM-rheumatoid factor synthesis.
T cell depletion has been demonstrated to have therapeutic potential in patients with rheumatoid arthritis and several agents which deplete or inactivate T cells are currently being evaluated in clinical trials. We treated six patients with active rheumatoid arthritis with one such agent, the murine IgG1 anti-CD5 immunoconjugate CD5 Plus, as part of a multicenter trial. Measurement of in vitro synthesis of IgM and IgM-rheumatoid factor by peripheral blood mononuclear cells obtained from patients before, during, and after treatment, was performed using enzyme-linked immunoassays. Subsets of T and B lymphocytes were measured by flow cytometry. Significant T cell depletion was observed on Days 2 and 5 during the treatment period and was associated with increased in vitro rheumatoid factor (RF) production on Days 5 and 8 in 4 of the 5 patients with significant pretreatment levels of RF synthesis. No apparent relationship to serum RF levels or clinical responses was noted. These results implicate a role for T cells in the control of IgM-RF production in patients with rheumatoid arthritis.
Olsen
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Vanderbilt University, Nashville, Tennessee 37232.
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D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology; D018956:CD5 Antigens; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis*; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000096:biosynthesis*; D013601:T-Lymphocytes / Q000276:immunology*
D015703:Antigens, CD; D018956:CD5 Antigens; D007075:Immunoglobulin M; D012217:Rheumatoid Factor