Mowat A G, Baum J
J Clin Invest. 1971 Dec;50(12):2541-9. doi: 10.1172/JCI106754.
Using a new in vitro method of measuring the chemotaxis of polymorphonuclear leukocytes from peripheral blood, a chemotactic index has been calculated. The mean chemotactic index of 320 in 24 patients with definite rheumatoid arthritis, was significantly less (P < 0.0005) than the mean of 555 in 24 normal controls matched for age and sex. The mean chemotactic index of 435 in eight patients with juvenile rheumatoid arthritis was also significantly less (P < 0.01) than that of 553 in similarly matched controls. The chemotactic index could not be correlated with age, sex, disease activity, drugs used in treatment, latex titer, immunoglobulin levels, or protein coating on the cells. However, there was a correlation between the chemotactic index and the serum complement B(1e)/B(1a) value (P < 0.01) in 17 patients with adult onset rheumatoid arthritis. Although the serum complement B(1e)/B(1a) values were within the normal range, the lowest chemotactic indices were associated with the lowest complement values. The chemotactic indices in three patients with severe connective tissue disease (seropositive rheumatoid arthritis, systemic lupus erythematosus, and polymyositis) returned to normal after 5 days' treatment with 60 mg of prednisolone per day. Incubation of the cells from patients with rheumatoid arthritis with hydrocortisone in vitro failed to alter the chemotactic indices. Prior incubation of normal cells with purified rheumatoid factor complexes, rheumatoid serum, or macromolecules of iron dextran impaired their chemotaxis. It is suggested that phagocytosis of complexes in vivo is a possible mechanism by which the chemotaxis of the polymorphonuclear leukocytes of patients with rheumatoid arthritis is impaired. This impairment in chemotaxis may explain the increased incidence of bacterial infection, both during life and as a cause of death in these patients.
利用一种新的体外测量外周血多形核白细胞趋化性的方法，计算出了趋化指数。24例确诊类风湿性关节炎患者的平均趋化指数为320，显著低于24例年龄和性别相匹配的正常对照者的平均趋化指数555（P<0.0005）。8例青少年类风湿性关节炎患者的平均趋化指数为435，也显著低于相似匹配对照者的553（P<0.01）。趋化指数与年龄、性别、疾病活动度、治疗所用药物、乳胶滴度、免疫球蛋白水平或细胞上的蛋白包被均无相关性。然而，在17例成年发病的类风湿性关节炎患者中，趋化指数与血清补体B(1e)/B(1a)值存在相关性（P<0.01）。尽管血清补体B(1e)/B(1a)值在正常范围内，但最低的趋化指数与最低的补体值相关。3例严重结缔组织病（血清阳性类风湿性关节炎、系统性红斑狼疮和多发性肌炎）患者每天服用60mg泼尼松龙治疗5天后，趋化指数恢复正常。类风湿性关节炎患者的细胞在体外与氢化可的松孵育未能改变趋化指数。正常细胞预先与纯化的类风湿因子复合物、类风湿血清或右旋糖酐铁大分子孵育会损害其趋化性。提示体内复合物的吞噬作用可能是类风湿性关节炎患者多形核白细胞趋化性受损的一种机制。这种趋化性受损可能解释了这些患者在生前和作为死亡原因时细菌感染发生率增加的现象。
