Calabrese L H, Taylor J V, Wilke W S, Segal A M, Valenzuela R, Clough J D
Department of Rheumatic and Immunologic Disease, Cleveland Clinic Foundation, Ohio 44195.
Cleve Clin J Med. 1990 May;57(3):232-41. doi: 10.3949/ccjm.57.3.232.
In an attempt to define the immunoregulatory mechanisms operating in rheumatoid arthritis, the authors examined peripheral blood functional lymphocyte subsets in 15 patients with active rheumatoid arthritis who were not receiving remittive therapy, as well as 33 healthy controls. The percentage and absolute numbers of total T cells (CD3), T-helper/inducer cells (CD4), and T-suppressor/cytotoxic cells (CD8) did not differ among the groups, nor did the CD4:CD8 ratio or the numbers of T cells coexpressing CD4 and the activation markers Ia or IL-2R. However, rheumatoid arthritis patients did have reduced percentages and numbers of CD4+ cells coexpressing the 2H4 antigen (CD45R-naive T cells) (P less than .0003) and CD8+ cells coexpressing the Leu-15 (CD11b) marker (suppressor/effectors) (P less than .0005). Twelve patients then received oral methotrexate, 7.5 mg weekly. Most showed clinical improvement by 4 weeks and all did by 8 weeks. Although changes in the T-cell subsets were not statistically significant, several tended toward normalization. These findings may help explain the immunoregulatory defect in rheumatoid arthritis and the effectiveness of methotrexate in modifying disease activity.
为了确定类风湿性关节炎中起作用的免疫调节机制，作者检测了15例未接受缓解治疗的活动性类风湿性关节炎患者以及33名健康对照者外周血功能性淋巴细胞亚群。各组之间总T细胞（CD3）、辅助性/诱导性T细胞（CD4）和抑制性/细胞毒性T细胞（CD8）的百分比及绝对数量均无差异，CD4:CD8比值或共表达CD4与激活标志物Ia或IL-2R的T细胞数量也无差异。然而，类风湿性关节炎患者共表达2H4抗原的CD4+细胞（CD45R-幼稚T细胞）（P<0.0003）和共表达Leu-15（CD11b）标志物的CD8+细胞（抑制性/效应性细胞）（P<0.0005）的百分比和数量确实减少。随后，12例患者接受口服甲氨蝶呤治疗，每周7.5mg。大多数患者在4周时出现临床改善，所有患者在8周时均有改善。虽然T细胞亚群的变化无统计学意义，但有几个指标有趋于正常化的趋势。这些发现可能有助于解释类风湿性关节炎中的免疫调节缺陷以及甲氨蝶呤改善疾病活动的有效性。
