The sequential analysis of T lymphocyte subsets and interleukin-6 in polymyalgia rheumatica patients as predictors of disease remission and steroid withdrawal.
CD4 and CD8 T lymphocyte subsets, the late T cell activation marker, HLA-DR, and serum interleukin-6 (IL-6) levels of 57 polymyalgia rheumatica (PMR) patients were followed over 2 yr to investigate whether they could be used to predict the safe withdrawal of steroid therapy. Cell phenotypes were studied by flow cytometry and IL-6 levels by ELISA. %CD8 cells were reduced below the normal range in PMR patients prior to steroid therapy. In 56% of patients, the %CD8 T lymphocytes failed to return to normal levels when quiescent disease allowed cessation of steroid therapy. Activated CD8 T cells, as detected by HLA-DR positivity, were above the normal range at the initiation of therapy and showed a negative correlation with %CD8 T cells. The serum concentration of IL-6 fluctuated over 24 months, and the correlation between IL-6 and erythrocyte sedimentation rate (ESR) seen prior to treatment was not seen at later intervals. The %CD8 T cell and serum IL-6 levels are not a good indicator of disease activity in PMR and are, therefore, unable to predict the safe withdrawal of steroids.
Corrigall
V M
VM
Rheumatology Unit, Guy's Hospital, London.
Dolan
A L
AL
Dasgupta
B
B
Panayi
G S
GS
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000737:chemistry / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000737:chemistry / Q000276:immunology; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007273:Injections, Intramuscular; D015850:Interleukin-6 / Q000097:blood*; D008775:Methylprednisolone / Q000008:administration & dosage; D011111:Polymyalgia Rheumatica / Q000188:drug therapy* / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage*; D012075:Remission, Spontaneous; D016176:T-Lymphocyte Subsets / Q000276:immunology
D000893:Anti-Inflammatory Agents; D006684:HLA-DR Antigens; D015850:Interleukin-6; D011239:Prednisolone; D008775:Methylprednisolone