[Study of lymphocyte subpopulations in chronic autoimmune inflammatory rheumatic diseases. II. Polymyalgia rheumatica: behaviour of lymphocyte subpopulations during treatment with two different corticosteroids].
OBJECTIVE
The aim of this paper was to study the distribution of CD8+ subsets, of soluble receptors of CD8 and IL-2 during a steroid treatment with prednisone and deflazacort.


METHODS
Forty-eight patients (9 males and 39 females, mean age 69.4(6.5 years) with active polymyalgia rheumatica (ESR 74 (18 mm, 1(st) h) were studied. In order to determine the distribution of lymphocyte subpopulations a panel of monoclonal antibodies was utilised. Flow cytometry with a FACSCAN machine and ELISA method were utilized.


RESULTS
At base-time in comparison with normal subjects: reduction (P<0.05) of CD4(-)/CD8(+) (356+/-112/mL vs 564(132/mL), due to reduction (P<0.001) of CD8(+)bright (224(86/mL vs 426+/-124/mL) and CD8(+)bright/CD57(-) (123+/-44/mL vs 256(58/mL); increasing (P<0.001) of sCD8 (514+/-123 U/mL vs 312+/-102 U/mL) and (P<0.005) sIL-2r (984(346 U/mL vs 244+/-58 U/mL). Group-PDN: significant (P<0.001) reduction of CD4(-)/CD8(+) (466+/-102), CD89(+))bright (302(74), CD8+bright/CD57- (186+/-51), sCD8 (418+/-96) and of sIL-2r (450+/-163) at 1(st) week, and toward the normal range at 1(st) month. Group-DFZ: normal values at 6th month: CD4(-)/CD8(+) (497+/-133), CD8(+)bright (401+/-98), CD8(+)bright/CD57(-) (240+/-64), sCD8 (317+/-82), while sIL-2r è (P<0.0005) higher vs group-PDN. Group-PDN: VES <50 at 1st week, normal value (14+/-7) at 3(rd) month; PCR, 2.2+/-1.2 at 3(rd) month and 1(0.8 at 6th month. Group-DFZ: VES >20 (24+/-5) at 6th month e PCR increased.


CONCLUSIONS
PDN shows a faster action vs DFZ. DFZ does not seem to be able in reducing sIL-2r probably showing a persistent inflammation and immune activation status.
Coaccioli
S
S
Scuola di Specializzazione in Reumatologia Clinica Medica, Università degli Studi di Perugia Azienda Ospedaliera Santa Maria, Terni, Italy. scoaccioli@tin.it
Pinoca
F
F
Giuliani
M
M
Sabatini
C
C
Puxeddu
A
A
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016516:CD4-CD8 Ratio; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018655:Lymphocyte Count; D008297:Male; D011111:Polymyalgia Rheumatica / Q000188:drug therapy* / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use*; D011282:Pregnenediones / Q000627:therapeutic use*; D011948:Receptors, Antigen, T-Cell / Q000032:analysis; D016176:T-Lymphocyte Subsets / Q000187:drug effects*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D011282:Pregnenediones; D011948:Receptors, Antigen, T-Cell; C021988:deflazacort; D011241:Prednisone