title: Effects of inoculation with attenuated autologous T cells in patients with rheumatoid arthritis.
abstract: Injection of attenuated autoimmune T cells, T cell vaccination, has been used successfully in the prevention and treatment of experimental animal autoimmune disease. In order to determine whether such a procedure might be applied in rheumatoid arthritis (RA), a phase I study was conducted in thirteen RA patients with a mean disease duration of 12.8 years. All patients received a subcutaneous injection of attenuated autologous T lymphocytes from a CD4 positive clone (n = 4) or line (n = 9) isolated from synovial tissue (n = 3) or synovial fluid (n = 10). No toxic side effects were observed. On the average the patients showed a slight decrease in disease activity which was most marked at 8 weeks after the injection. Specific immune reactivity against the injected T cells was not detected, with the possible exception of one patient who was vaccinated with a clone selected in vitro with antigen and whose disease had begun one year earlier. In this patient a clear decrease in disease activity occurred, which was associated with a decrease in mitogen-induced proliferation of her peripheral blood mononuclear cells and in titres of serum rheumatoid factors. The results of this study show that inoculation of RA patients with autologous T cells is technically feasible and non-toxic, and may be associated with clinical and immunological effects. The data suggest that the potential of T cell vaccination should be further explored in diseases with defined antigen reactivity.
authors.affiliation: Department of Rheumatology, University Hospital, Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: van Laar
authors.forename: A M
authors.initials: AM
authors.lastname: Miltenburg
authors.forename: M J
authors.initials: MJ
authors.lastname: Verdonk
authors.forename: A
authors.initials: A
authors.lastname: Leow
authors.forename: B G
authors.initials: BG
authors.lastname: Elferink
authors.forename: M R
authors.initials: MR
authors.lastname: Daha
authors.forename: I R
authors.initials: IR
authors.lastname: Cohen
authors.forename: R R
authors.initials: RR
authors.lastname: de Vries
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000628:therapy*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007165:Immunosuppression Therapy / Q000379:methods*; D016233:Immunotherapy, Active; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000097:blood; D013582:Synovial Fluid / Q000166:cytology; D013583:Synovial Membrane / Q000166:cytology
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012217:Rheumatoid Factor