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Delayed type hypersensitivity in patients with rheumatoid arthritis
R M Pope1, W T Kniker, N Talal
1Northwestern University, Department of Medicine, Chicago, IL 60611.
The Journal of Rheumatology
|January 1, 1993
Summary
This study found that while anergy is rare in rheumatoid arthritis (RA) patients, decreased delayed type hypersensitivity (DTH) responses correlate with higher disease activity, specifically indicated by erythrocyte sedimentation rate (ESR).
Area of Science:
- Immunology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Delayed type hypersensitivity (DTH) is a measure of cellular immune function.
- The relationship between DTH and RA activity requires further investigation.
Purpose of the Study:
- To investigate the association between in vivo DTH responses and clinical/laboratory markers of RA activity.
- To assess DTH responsiveness in RA patients not on immunosuppressive therapy.
Main Methods:
- Eleven RA patients, untreated with disease-modifying drugs, immunosuppressants, or corticosteroids, were evaluated.
- In vivo DTH was assessed using the Multitest CMI system with 7 antigens.
- Erythrocyte sedimentation rate (ESR), synovitis, and specific lymphocyte populations were analyzed.
Main Results:
- No RA patients exhibited true anergy, but 3 out of 11 were hyporesponsive.
- Total in vivo DTH responses did not differ significantly between RA patients and controls.
- A significant positive correlation was found between total DTH and ESR, a marker of RA disease activity.
Conclusions:
- Decreased DTH responses in RA patients are associated with increased disease activity, as indicated by ESR.
- DTH responsiveness does not correlate with synovitis or specific T-lymphocyte subsets in this RA cohort.
- Anergy is uncommon in RA patients, but hyporesponsiveness may reflect disease activity.