Immunological aspects of the anemia of rheumatoid arthritis

In order to investigate the cause of the anemia concomitant with rheumatoid arthritis (RA), we examined, using the erythroid colony assay of human bone marrow colony-forming units-erythroid (CFU-e) and burst-forming units-erythroid (BFU-e), the effects of the patients' serum and peripheral blood T lymphocytes on the CFU-e-derived colonies. The counts of erythroid colonies of RA patients were markedly lower than those of human control subjects [CFU-e: control 152.9 +/- 30.6 (n = 19), RA 51.1 +/- 13.6 (n = 7), t = 7.66567, p less than 0.01; BFU-e: control 25.2 +/- 5.9 (n = 5), RA 12.6 +/- 2.6 (n = 7), t = 4.574, p less than 0.01]. The serum from two out of seven RA patients slightly inhibited the formation of CFU-e-derived colonies of human control subjects (t = 2.31, 0.05 less than p less than 0.1); however, the serum from the other five RA patients did not significantly inhibit human control erythroid colony formation as compared with human control serum (t = 0.981, 0.3 less than p less than 0.4). On the other hand, peripheral blood T lymphocytes of the patients markedly inhibited the formation of CFU-e-derived colonies of the control subjects as compared with peripheral blood T lymphocytes from human control subjects (t = 4.24, p less than 0.01). The above-mentioned results suggest that the peripheral blood T lymphocytes of RA patients might play a role as one of the causes of the concomitant anemia of RA patients.