Analysis of peripheral blood lymphocytes using flow cytometry in polymyalgia rheumatica, RS3PE and early rheumatoid arthritis.

OBJECTIVE

Clinical pictures of poly-myalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) are often indistinguishable from those of early rheumatoid arthritis (RA). To investigate whether there is a difference in immunological aspects among these 3 disorders, we performed a phenotypic analysis of peripheral blood lymphocytes.

PATIENTS AND METHODS

Eleven patients with early RA, 14 with PMR and 11 with RS3PE were enrolled in this study. After separation of mononuclear cells from peripheral blood using the Ficoll-Hypaque method, surface markers and intracellular cytokines of lymphocytes were analyzed by 2- or 3-color flow cytometry.

RESULTS

Both PMR and RS3PE showed a significant decrease in CD8CD25 cells (p<0.05), and significant increases in CD4IFN-gammaIL-4- (p<0.05), CD8IFN-gammaIL-4- (p<0.05 and p<0.01, respectively) and CD4TNF-alpha cells (p<0.05) compared with early RA. CD3CD4 cells were higher in PMR than in RS3PE (p<0.01), but there were no significant differences in any other phenotypes between these disorders.

CONCLUSION

A decrease in activated cytotoxic/suppressor T cells and increases in circulating Th1 and Tc1 cells may be common characteristics of PMR and RS3PE in comparison with early RA. Both disorders are clearly different from early RA, and probably belong to the same disease entity with regard to phenotypes of peripheral blood lymphocytes.