title: Assessment of peripheral blood CD4+ adenosine triphosphate activity in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  The ability of the ImmuKnow (Cylex) assay to predict the risk of infection in rheumatoid arthritis (RA) patients receiving synthetic or biological disease-modifying antirheumatic drugs (DMARDs) was examined.
  
  
  METHODS
  The amount of adenosine triphosphate (ATP) produced by CD4+ cells in response to phytohemagglutinin was measured in whole blood from 117 RA patients without infection versus 17 RA patients with infection, and compared with results in 75 healthy controls.
  
  
  RESULTS
  The mean ATP level was significantly lower in patients with infection compared to both healthy controls (P < 0.0005) and patients without infection (P = 0.040). Also, the mean ATP level in patients without infection was significantly lower than that in healthy controls (P = 0.012). There was no correlation between the ATP level and the Disease Activity Score in 28 joints.
  
  
  CONCLUSIONS
  ImmuKnow assay results may be effective in identifying RA patients at increased risk of infection, but the results showed no correlation with RA activity. Larger studies are required to establish the clinical advantages of this assay in RA treatment.
authors.affiliation: Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Akimoto
authors.forename: Shingo
authors.initials: S
authors.lastname: Yunoue
authors.forename: Hideo
authors.initials: H
authors.lastname: Otsubo
authors.forename: Tamami
authors.initials: T
authors.lastname: Yoshitama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Kodama
authors.forename: Kakushi
authors.initials: K
authors.lastname: Matsushita
authors.forename: Yukio
authors.initials: Y
authors.lastname: Suruga
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kozako
authors.forename: Shingo
authors.initials: S
authors.lastname: Toji
authors.forename: Sachi
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Kimiharu
authors.initials: K
authors.lastname: Uozumi
authors.forename: Takemasa
authors.initials: T
authors.lastname: Matsuda
authors.forename: Naomichi
authors.initials: N
authors.lastname: Arima
mesh_terms: D000255:Adenosine Triphosphate / Q000097:blood*; D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007239:Infections / Q000150:complications* / Q000209:etiology; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010835:Phytohemagglutinins / Q000494:pharmacology; D011237:Predictive Value of Tests; D012306:Risk; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D010835:Phytohemagglutinins; D000255:Adenosine Triphosphate