Andrianakos A A, Sharp J T, Person D A, Lidsky M D, Duffy J
Ann Rheum Dis. 1977 Feb;36(1):13-20. doi: 10.1136/ard.36.1.13.
Cell-mediated immunity in rheumatoid arthritis (RA) was assessed by skin testing with six antigens in 107 patients, 94 of whom were age, sex, and race-matched with healthy individuals or patients with diseases unrelated to immunological abnormalities. 20% of RA patients were anergic. Impaired cell-mediated immunity in the RA patients was manifested by a decrease in the magnitude of skin reactivity as well as a decrease in the incidence of positive reactions to multiple antigens. Depression in cell-mediated immunity was related to age but not to sex, duration of disease, or disease activity. A slight correlation was found between absolute peripheral lymphocyte counts and the number of positive skin tests, and was confirmed by finding an association between lymphocyte counts and the size of skin reactions. A correlation was also found between lymphocyte counts and disease activity. Four explanations of the observed depression in cell-mediated immunity in RA were considered: (1) a preoccupation of the immune mechanism of the host with cell-mediated immunity reactions related to the pathogenesis of the disease; (2) a depression of cell-mediated immune reactivity by a virus infection; (3) depression of cell-mediated immunity by therapy; and (4) immune complex suppression of cell-mediated immunity. No effect of gold therapy was found. The near universal use of salicylates or other anti-inflammatory drugs did not permit investigation of the effect of these drugs on cell-mediated immunity.
通过对107例类风湿关节炎（RA）患者进行六种抗原的皮肤试验来评估细胞介导免疫，其中94例患者在年龄、性别和种族上与健康个体或与免疫异常无关疾病的患者相匹配。20%的RA患者无反应性。RA患者细胞介导免疫受损表现为皮肤反应强度降低以及对多种抗原阳性反应的发生率降低。细胞介导免疫的抑制与年龄有关，而与性别、病程或疾病活动度无关。外周血淋巴细胞绝对计数与皮肤试验阳性数量之间存在轻微相关性，并且通过发现淋巴细胞计数与皮肤反应大小之间的关联得到证实。淋巴细胞计数与疾病活动度之间也存在相关性。对RA中观察到的细胞介导免疫抑制有四种解释：（1）宿主免疫机制专注于与疾病发病机制相关的细胞介导免疫反应；（2）病毒感染导致细胞介导免疫反应性降低；（3）治疗导致细胞介导免疫抑制；（4）免疫复合物对细胞介导免疫的抑制。未发现金制剂治疗的影响。水杨酸酯或其他抗炎药物的广泛使用使得无法研究这些药物对细胞介导免疫的影响。
