The role of Ia positive T cells in patients with rheumatoid arthritis.

In peripheral blood and synovial fluid of patients with rheumatoid arthritis (RA), increased levels of Ia antigen-positive (Ia+) T cells have been demonstrated. Therefore, we examined these Ia+ T cells in vitro to identify their role in the production of rheumatoid factor (RF) and to study the immunologic abnormalities of RA. When Ia+ T cells from peripheral blood of RA patients were added to pokeweed mitogen (PWM)-non-stimulated autologous B cells, the amount of IgM-RF production was 25.8 +/- 6.4 (mean +/- SE) (p less than 0.001) as compared to 16.0 +/- 4.6 ng/ml (mean +/- SE) in the presence of Ia-T cells. When Ia-OKT4+ cell fractions, obtained by excluding Ia+ T cells from OKT4+ cells, were added to B cells, the increase in IgM-RF production was markedly lower than that obtained with the OKT4+ cell fraction. These results indicate that the helper T cells which induce the production of IgM-RF may derive from the Ia+ OKT4+ cell fraction. B cells from rheumatoid synovial fluid produced IgM-RF levels as high as 102.7 +/- 19.2 ng/ml (mean +/- SE) even without stimulation. When T cells from autologous synovial fluid were added, IgM-RF production was not increased. These data suggest that B cells from RA synovial fluid had already been activated. When synovial fluid T cells were added to B cells from autologous peripheral blood, larger amounts of IgM-RF were produced as compared to experiments in which T cells from peripheral blood were added, suggesting that T cells from synovial fluid induced an enhanced IgM-RF production by B cells.(ABSTRACT TRUNCATED AT 250 WORDS)