[Suppression of monocyte-macrophage activation by anti-CD4 therapy in patients with chronic polyarthritis]

Monoclonal anti-CD4 antibodies have been introduced into the treatment of rheumatoid arthritis. A depletion of CD4+ T-cells down to 8% of the origin level (p less than 0.0001) followed the antibody application. Moreover, there was a significant reduction of blood monocytes to 30% (p less than 0.001). A reduced lymphocyte proliferation induced by antigens or mitogens was found in parallel. Prior to treatment, monocyte-macrophage activation in rheumatoid arthritis was signified by an increased expression of HLA-class II antigens and the CD14 antigen, and by an increased production of neopterin and interleukin-1. Anti-CD4 treatment resulted in a significant reduction of elevated levels of neopterin, beta 2-microglobulin in serum as well as IL-1 production in vitro.