Transient immunoregulatory perturbation during the acute phase of rheumatic fever

An abnormal immune response directed at streptococcal antigen is currently thought to be involved in the development of autoimmune phenomena in rheumatic fever (RF). We studied T-cell subsets using the OKT monoclonal antibodies in 13 patients with newly-diagnosed RF. No difference was found in the total number of T cells or in the proportion of helper T cells (OKT4+) at the acute phase (56.6 +/- 6.9) as compared to the recovery phase (55.2 +/- 9.2). However, a significantly decreased proportion of suppressor T cells (OKT8+) was observed during the acute phase (17.2 +/- 6) as compared to the recovery phase (26.4 +/- 5.3) (p less than 0.001). The T4/T8 ratio was significantly higher during the initial phase (3.65 +/- 1.04) and returned to normal later (2.12 +/- 0.39) (p less than 0.002). The results of our study indicate that in the acute phase of RF many patients had low levels of suppressor T cells which return to normal after recovery. Thus, reduced proportion of suppressor T cells might be an indicator for the active phase of RF. Decreased suppressor cell activity may also be involved in the development of autoimmune phenomena in RF.