Synovial lymphocyte subsets in rheumatoid arthritis and degenerative joint disease

There is considerable evidence to indicate that the synovitis of rheumatoid arthritis (RA) is immunologically mediated. Recently, it has been postulated that a suppressor-type cell deficiency may play an important role in the pathogenesis of the synovitis. In addition, an immune component may contribute to the synovial alterations in certain examples of degenerative joint disease (osteoarthritis, OA). Using monoclonal antibodies, we evaluated synovial tissue lymphocytes in 12 patients with RA, 2 with juvenile RA, one with adult Still's disease, and 2 patients with OA synovitis in order to delineate the T cell subset patterns. Helper-type cells predominated in 3 patients with RA, while suppressor-type cells were present in equal or greater numbers in 9. The patients with OA showed helper-type cell predominance. Helper-type to suppressor-type cell ratios vary widely in RA synovia which militates against the primacy of the role of a suppressor-type cell deficiency in this disorder. Patients with OA synovitis may display T cell infiltrates comprised mainly of helper-type cells.