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Histologic changes in rheumatoid synovitis induced by naproxen and methotrexate
A Balsa1, C Gamallo, E Martín-Mola
1Rheumatology Unit, Hospital La Paz, Madrid, Spain.
The Journal of Rheumatology
|September 1, 1993
Summary
Methotrexate (MTX) significantly reduced T cells in rheumatoid synovitis, improving clinical activity. Naproxen showed no significant effect on rheumatoid synovitis or T cell infiltration.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Rheumatoid synovitis involves inflammation and immune cell infiltration of the synovial membrane.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and methotrexate (MTX) are used to manage rheumatoid arthritis.
- Understanding the cellular changes induced by these treatments is crucial for optimizing therapy.
Purpose of the Study:
- To investigate the effects of naproxen and methotrexate on cellular changes in rheumatoid synovitis.
- To correlate these cellular changes with clinical improvements.
Main Methods:
- A study involving 12 patients treated with naproxen and 11 with MTX.
- Clinical activity index measured before and after treatment.
- Synovial biopsies analyzed for CD3, CD4, CD8, CD19, LeuM5, HLA-DR, HLA-DP, and CD25 antigen-expressing cells using stereology.
Main Results:
- Methotrexate treatment led to a significant reduction in CD3+, CD4+, and HLA-DR+ cells.
- Patients receiving MTX showed a significant improvement in the clinical activity index.
- Naproxen treatment did not result in significant changes in the clinical activity index or synovial infiltrate composition.
Conclusions:
- Clinical improvement in rheumatoid synovitis correlates with a decrease in synovial T cell infiltration.
- Methotrexate demonstrates efficacy in reducing key immune cell populations in rheumatoid synovitis.
- Naproxen may not effectively modulate the immune infiltrate in rheumatoid synovitis.