Effects of nonsteroidal antiinflammatory drugs on the immune network.

The immune system is extremely complex. It comprises many different types of cells and their products. In patients with rheumatic diseases the immune system is activated and has disturbed regulation. It is also believed that immune reactions are involved in the pathogenesis of these disorders. Nonsteroidal antiinflammatory drugs (NSAID) have therapeutic effects on rheumatic diseases. These effects can all be explained by inhibition of prostaglandin production locally in the diseased joints, leading to reduced inflammation. Little or no effects on the number of circulating lymphocyte subpopulations or on peripheral blood mononuclear cell immune reactions can be seen after treatment of patients with rheumatoid arthritis (RA) with NSAID. The possibility, however, exists that immune reactions locally in the diseased joints are modulated by NSAID secondary to reduced prostaglandin production.