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Analysis of peripheral blood lymphocytes using flow cytometry in polymyalgia rheumatica, RS3PE and early rheumatoid
Y Shimojima1, M Matsuda, W Ishii
1Department of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan.
Objective:
Clinical pictures of poly-myalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) are often indistinguishable from those of early rheumatoid arthritis (RA). To investigate whether there is a difference in immunological aspects among these 3 disorders, we performed a phenotypic analysis of peripheral blood lymphocytes.
Patients And Methods:
Eleven patients with early RA, 14 with PMR and 11 with RS3PE were enrolled in this study. After separation of mononuclear cells from peripheral blood using the Ficoll-Hypaque method, surface markers and intracellular cytokines of lymphocytes were analyzed by 2- or 3-color flow cytometry.
Results:
Both PMR and RS3PE showed a significant decrease in CD8+CD25+ cells (p<0.05), and significant increases in CD4+IFN-gamma+IL-4- (p<0.05), CD8+IFN-gamma+IL-4- (p<0.05 and p<0.01, respectively) and CD4+TNF-alpha+ cells (p<0.05) compared with early RA. CD3+CD4+ cells were higher in PMR than in RS3PE (p<0.01), but there were no significant differences in any other phenotypes between these disorders.
Conclusion:
A decrease in activated cytotoxic/suppressor T cells and increases in circulating Th1 and Tc1 cells may be common characteristics of PMR and RS3PE in comparison with early RA. Both disorders are clearly different from early RA, and probably belong to the same disease entity with regard to phenotypes of peripheral blood lymphocytes.
Insights
Poly-myalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) share decreased activated T cells and increased Th1/Tc1 cells compared to early rheumatoid arthritis (RA). These immunological findings suggest PMR and RS3PE may represent a single disease entity distinct from RA.
Area of Science:
- Immunology
- Rheumatology
- Cell Biology
Background:
- Clinical presentation of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) can mimic early rheumatoid arthritis (RA).
- Distinguishing these conditions based solely on clinical symptoms is challenging.
Purpose of the Study:
- To investigate immunological differences between early RA, PMR, and RS3PE.
- To determine if peripheral blood lymphocyte phenotypes can differentiate these rheumatological disorders.
Main Methods:
- Phenotypic analysis of peripheral blood lymphocytes was conducted on patients with early RA, PMR, and RS3PE.
- Flow cytometry was used to analyze surface markers and intracellular cytokines of lymphocytes.
Main Results:
- PMR and RS3PE exhibited significantly lower CD8+CD25+ cells compared to early RA.
- Elevated levels of CD4+IFN-gamma+IL-4-, CD8+IFN-gamma+IL-4-, and CD4+TNF-alpha+ cells were observed in PMR and RS3PE versus early RA.
- CD3+CD4+ cells were higher in PMR than in RS3PE, with no other significant phenotypic differences between PMR and RS3PE.
Conclusions:
- A reduction in activated cytotoxic/suppressor T cells and an increase in circulating Th1 and Tc1 cells are common immunological characteristics of PMR and RS3PE when compared to early RA.
- The distinct lymphocyte phenotypes indicate that PMR and RS3PE are immunologically different from early RA.
- Based on peripheral blood lymphocyte phenotypes, PMR and RS3PE likely represent the same disease entity.
