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Abstract
The monoclonal antibodies anti-2H4 and anti-4B4 identify the suppressor-inducer (CD4+2H4+)
and helper-inducer (CD4+4B4+) subpopulations of CD4 (T4+) lymphocytes, respectively.
The cell surface phenotype of peripheral blood lymphocytes and synovial fluid lymphocytes
in patients with rheumatoid arthritis and other inflammatory joint diseases was analyzed
by use of these and other well-characterized anti-T-cell monoclonal antibodies. In
the synovial fluid of patients with rheumatoid arthritis, there was a markedly decreased
percentage of T4+2H4+ suppressor-inducer cells (3.1 ± 1 percent) and an increased
percentage of T4+4B4+ helper-inducer cells (29.1 ± 9 percent) as compared with the
proportions found in the peripheral blood of normal individuals (T4+2H4+: 19.0 ± 6
percent, T4+4B4+: 23.0 ± 7 percent). Moreover, patients with other chronic and acute
inflammatory joint diseases exhibited highly similar synovial T-cell findings to those
of the patients with rheumatoid arthritis (T4+2H4+: 4.2 ± 3 percent, T4+4B4+: 33.1
± 9 percent). In contrast, there were no significant differences between the normal
control subjects and patients with rheumatoid arthritis in the percentage of T4+2H4+
cells in peripheral blood lymphocytes, nor were there significant differences between
normal control subjects, patients with rheumatoid arthritis, and patients with other
joint diseases (osteoarthritis, gout, B27+ spondyloarthropathy, and psoriatic arthritis)
in the number of T4+4B4+ cells or in the T4/T8 ratio of peripheral blood lymphocytes.
However, very low numbers of T4+2H4+ (suppressor-inducer) peripheral blood lymphocytes
were seen in a subgroup of patients, including five of seven with Reiter's syndrome
and several patients with systemic rheumatic disease syndromes. In addition, although
the percentage of T4+2H4+ cells in peripheral blood lymphocytes of patients with osteoarthritis
(13.7 ± 7 percent) and gout (14.3 ± 7 percent) was decreased compared with that of
normal controls (19.0 ± 6 percent) (osteoarthritis versus normal controls p <0.025),
this difference appeared to reflect alterations due to age rather than disease. Consistent
with the phenotypic changes observed, synovial T cells were also functionally defective,
since autologous mixed lymphocyte reaction-activated T4 cells from the synovial fluid
of patients with rheumatoid arthritis failed to exhibit suppressor-inducer activity.
The results indicate that diminished proportions of CD4+2H4+ (suppressor-inducer)
cells and increased proportions of CD4+4B4+ (helper) cells are a common feature of
CD4+ cells in synovial fluid in rheumatoid arthritis as well as a variety of other
inflammatory disorders, whereas modest changes in CD4+2H4+ peripheral blood lymphocytes
are seen in older individuals and more marked decreases are observed only in a more
selected group of patients. These changes may be of potential functional importance
in the regulation of the immune response in a variety of clinical settings.
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Rudd CE, Morimoto C, Bush C, Wong L, Schlossman SF: The fibronectin receptor complex acts as a marker for a helper subset within the CD4+(T4+) population. Manuscript submitted.
Article Info
Publication History
Accepted:
March 10,
1988
Received:
November 25,
1987
Footnotes
☆This work was supported in part by Grants AI-12069, CA-19589, AM-33713, and AR-01590 from the National Institutes of Health, an Arthritis Foundation Arthritis Investigator Award (PLR), and an Arthritis Foundation Fellowship (PA).
Identification
Copyright
© 1988 Published by Elsevier Inc.
