The British Journal of Rheumatology, Vol 37, 7-14, Copyright © 1998 by British Society for Rheumatology
J Ronnelid, L Berg, S Rogberg, A Nilsson, K Albertsson and L Klareskog
We used a newly developed, sensitive ELISPOT technique in order to estimate
the number of cells producing interferon-gamma (IFN-gamma) and
interleukin-4 (IL-4) in synovial fluid mononuclear cells (SFMC) and
peripheral blood mononuclear cells (PBMC) in patients with rheumatoid
arthritis (RA) and other inflammatory arthritides, and to correlate the
results with clinical and laboratory parameters of disease activity. SFMC
and PBMC were cultured either without stimuli or with a standardized dose
of phytohaemagglutinin (PHA) for 6 h. Twenty-nine patients, 16 with RA and
13 with other inflammatory joint diseases, were investigated and compared
to PBMC from 25 healthy controls. The mean number of IFN-gamma-producing
cells was 37.1/10(5) plated SFMC (range 0-121.5). The corresponding value
for PBMC was 5.1 (0-39). The difference was highly significant (P = 0.0033
for RA patients, P = 0.0050 for non-RA patients and P < 0.0001 for all
patients). Forty-five per cent of SFMC samples (range for all samples
0-38.5 SFC/10(5) MNC) and 25% of PBMC samples (0-20.5) exhibited
spontaneous IL-4 production, yielding a significant difference for all
patients treated collectively (P = 0.021). Although the cells that
spontaneously secrete these cytokines are relatively few, quantification of
these cells thus shows increased functional T-cell activation and decreased
ratio of cells spontaneously producing IL-4 vs IFN-gamma in the joint fluid
as compared to blood of arthritis patients.
ORIGINAL PAPERS
Production of T-cell cytokines at the single-cell level in patients with inflammatory arthritides: enhanced activity in synovial fluid compared to blood
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
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