The British Journal of Rheumatology, Vol 37, 282-286, Copyright © 1998 by British Society for Rheumatology
A Kadioglu and P Sheldon
Eighteen patients with clinically active rheumatoid arthritis, satisfying
the ARA criteria, were admitted to hospital for i.v. methylprednisolone
pulse therapy. Studies of circulating lymphocyte subsets 1 h before and 24
h after pulsing were carried out together with studies on their adhesion to
endothelium-containing lamina propria of porcine gut at various time
points. Additionally, circulating VCAM-1 was estimated pre- and post-pulse
by ELISA. We observed a marked fall (59%) in mononuclear cell adhesion 24 h
post-pulse therapy (P < 0.001). Accompanying this was a significant,
though slight, fall in circulating mononuclear cells (P < 0.01), mainly
involving T cells. However, the degree of reduction in cell adhesion did
not appear to reflect change in any particular circulating subset, but was
more likely due to changes in adhesion molecule expression of several
subsets. No significant change in circulating VCAM-1 was observed. It would
appear, therefore, that the early beneficial effect of steroid pulsing in
rheumatoid arthritis coincides with a demonstrable reduction in cell
adhesion to gut. This may have implications for the pathogenesis of this
disease.
ORIGINAL PAPERS
Steroid pulse therapy for rheumatoid arthritis: effect on lymphocyte subsets and mononuclear cell adhesion
Department of Microbiology & Immunology, University of Leicester.
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