Autoreactivity to human heat-shock protein 60 predicts disease remission in oligoarticular juvenile rheumatoid arthritis.
OBJECTIVE
To determine whether T lymphocyte reactivity to endogenous human hsp60 plays a regulatory role in the course of oligoarticular juvenile rheumatoid arthritis (JRA).


METHODS
A prospective, longitudinal study of T cell reactivity to HSP in 15 patients with newly diagnosed HLA-B27 negative oligoarticular JRA was performed. Results were compared with those in a group of 20 patients with newly diagnosed polyarticular or systemic JRA or with acute arthritis caused by other systemic diseases or viral infections, as well as with those in a group of 9 healthy control subjects.


RESULTS
In 86% of the patients with oligoarticular JRA (13 of 15), significant T lymphocyte proliferative responses to hsp60 were found in peripheral blood mononuclear cells and/or synovial fluid mononuclear cells within 3 months after the onset of arthritis. Only 5% of the patients in the rheumatologic disease control group (1 of 20) showed such positivity. All patients with oligoarticular JRA and positive responses to human hsp60 developed a remission of their disease within 12 weeks. During this period of remission, blood samples were taken from 8 patients and showed significantly lower and even negative responses to hsp60, compared with active disease, when all 8 patients had good responses.


CONCLUSIONS
The results show that significant proliferative responses to human hsp60 can be found early in the course of oligoarticular JRA. Furthermore, these responses correlate with disease activity in such a manner that T cell reactivity to human hsp60 seems to be associated with disease remission.
University Hospital for Children and Youth, Het Wilhelmina Kinderziekenhuis, Department of Immunology, Utrecht, The Netherlands.
A B
AB
Prakken
W
W
van Eden
G T
GT
Rijkers
W
W
Kuis
E A
EA
Toebes
E R
ER
de Graeff-Meeder
R
R
van der Zee
B J
BJ
Zegers
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000276:immunology*; D015551:Autoimmunity; D002455:Cell Division; D002460:Cell Line; D018834:Chaperonin 60 / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000166:cytology
D018834:Chaperonin 60; D015796:HLA-B27 Antigen