T cell proliferative response to type II collagen in the inflammatory process and joint damage in patients with rheumatoid arthritis.
OBJECTIVE
To investigate the role of T cell responses to type II collagen (CII) in disease progression in patients with rheumatoid arthritis (RA).


METHODS
T cell proliferative responses to bovine CII by peripheral blood mononuclear cells (PBMC) from patients with early RA (duration < 5 yrs) were assayed by mixed lymphocyte culture. Clinical and laboratory variables including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were examined at the time of sampling. Radiographic damage on hand radiographs was evaluated by the method of Steinbrocker and Sharp.


RESULTS
In a cross sectional study, patients (n = 22) with positive T cell responses (stimulation index 2) had higher levels of CRP and ESR than those (n = 21) not showing T cell responses. The number of damaged joints (by Steinbrocker's method) and damaged joint scores (by Sharp's method) were significantly higher in patients with positive T cell responses than in those without. The joint space narrowing scores correlated well with T cell responsiveness to CII. Patients (n = 15) with both positive T cell responses and RA-susceptible allotypes HLA-DR1 or DR4 had higher damaged joint scores than the remainder of the patients (n = 24).


CONCLUSIONS
T cell proliferative responses to CII are associated with inflammatory activity and radiographic severity in RA. RA-susceptible allotypes positively relate to the radiographic progression associated with T cell responses to CII. Our data suggest that CII-reactive T cells may play a role in the pathogenic process of joint damage, especially in genetically susceptible patients.
Kim
Wan-Uk
WU
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, St. Vincent's Hospital, Suwon, South Korea. wan725@catholic.ac.kr
Kim
Ki-Jun
KJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001172:Arthritis, Rheumatoid / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D001175:Arthrography; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002417:Cattle; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D024043:Collagen Type II / Q000494:pharmacology*; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007596:Joints / Q000276:immunology* / Q000473:pathology; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013585:Synovitis / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*
D024043:Collagen Type II; D006684:HLA-DR Antigens; D002097:C-Reactive Protein