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Rheumatology 2002; 41: 1031-1039
© 2002 British Society for Rheumatology

Original Papers

Adrenaline-induced immunological changes are altered in patients with rheumatoid arthritis

J. M. Kittner, R. Jacobs, C. R. Pawlak1, C. J. Heijnen2, M. Schedlowski3 and R. E. Schmidt1

Department of Clinical Immunology, Hannover Medical School
1 Department of Medical Psychology, Hannover Medical School, Germany,
2 Laboratory for Psychoneuroimmunology, University Medical Center, Utrecht, The Netherlands and
3 Department of Medical Psychology, University of Essen, Germany

Objective. To investigate whether in rheumatoid arthritis (RA) patients the immunological changes induced by adrenaline are different from healthy controls (HC).

Methods. Fifteen female RA patients and 14 HC were infused with 1 µg/kg adrenaline over 20 min. Blood was drawn before, immediately after, and 1 h after the end of infusion. Lymphocyte subpopulations, cytokine production and natural killer cell cytotoxicity were determined.

Results. Subjects exhibited mild cardiovascular changes with no differences between patients and controls. CD16+CD56+CD3- NK cells increased by a factor of 5.7, CD3+ T cells by 1.5, monocytes by 1.6 and PMN by 1.2 in both groups. The numbers of IL-8- and IL-10-producing monocytes were higher in patients and presented a larger increase after infusion. NK cytotoxic activity was higher in RA patients and increased after infusion in both groups. Activated monocytes and T cells were preferentially recruited in patients and controls. Values returned to baseline 1 h later.

Conclusion. We describe an altered response to adrenaline in patients with RA with both pro- and anti-inflammatory effects. Additionally, activated T cells and monocytes recruited to the peripheral blood may influence disease activity.

KEY WORDS: Rheumatoid arthritis, Adrenaline infusion, Cytotoxicity, Cytokines, Chemokines, Activated T cells, CD14+CD16+ monocytes, Perforin.

Correspondence to: J. Kittner, Division of Clinical Immunology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. The first two authors contributed equally to this article.


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