Natural killer (NK) cell activity of peripheral blood, synovial fluid, and synovial tissue lymphocytes from patients with rheumatoid arthritis and juvenile rheumatoid arthritis

Natural killer (NK) cell activity was investigated in peripheral blood, synovial fluid, and synovial tissue lymphocytes from patients with rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA). Unfractionated lymphocytes, T lymphocytes, and non-T lymphocytes from the 3 compartments of JRA patients had reduced activity compared with that of normal peripheral blood lymphocytes (with p values usually between 0.05 and 0.1). Unfractionated synovial tissue lymphocytes of RA patients also showed reduced cytotoxicity (0.05 less than p less than 0.1), whereas peripheral blood lymphocytes exerted normal NK cell activity. The NK activity was exerted by cells both with and without Fc gamma receptors. The highest cytotoxicity was observed in Fc gamma receptor-positive cells, both in peripheral blood and synovial fluid, since more than 70% reduction in NK activity was found after depletion of Fc gamma receptor-positive cells. No evidence of lymphocytotoxic antibodies or other factors with influence on NK cells was observed in the patients' sera.

Demonstration of immunoglobulin-secreting cells in a sensitive reversed hemolytic plaque assay

A sensitive modification of a reversed hemolytic plaque assay demonstrating individual immunoglobulin-secreting cells (ISC) is presented. The test is performed by adding test cells to a monolayer of indicator sheep erythrocytes coated with an IgG fraction of rabbit antiserum against the F(ab')2 portion of human immunoglobulins (Ig). After having added a developing antiserum and complement, hemolytic plaques with a central ISC could be counted in an inverted microscope. In addition, when ISC were killed and fixed in situ in the monolayer, the cells could be further studied by immunofluorescence of their cytoplasmic Ig.

Autologous mixed lymphocyte reactions in patients with rheumatoid arthritis and juvenile rheumatoid arthritis: both non-T cells and in-vivo-activated T cells can act as stimulator cells

The lymphocyte responses in autologous mixed lymphocyte reactions (AMLR) between irradiated non-T and T lymphocytes from the peripheral blood (PB) of rheumatoid arthritis (RA) and juvenile RA (JRA) patients were decreased compared with the AMLR responses of normal PB lymphocytes. Normal AMLR responses were seen in synovial tissue and the synovial fluid lymphocytes from RA and JRA patients. The lymphocyte responses were also decreased in AMLR between irradiated non-T cells from peripheral blood and T cells from synovial tissue (ST) in RA patients and between irradiated non-T from PB and synovial fluid (SF) T cells in JRA patients. However, when irradiated non-T cells from ST of RA patients or from SF of JRA patients were mixed with autologous PB T lymphocytes, increased lymphocyte responses were observed. SF T lymphocytes and ST T cells were also shown to stimulate autologous PB T lymphocytes.

Deposition of immunoglobulin and complement in mucocutaneous lesions related to treatment with D-penicillamine

A 23-year-old man suffering from sero-negative rheumatoid arthritis developed severe penicillamine-induced mouth ulcerations and erythematous macules. Immunohistochemical staining in a biopsy specimen from the affected lingual mucosa showed substantial deposition of IgM and C3 in vessel walls below the necrotic epithelium. In the affected skin, irregular granular staining for IgG and IgM along the epidermal basement membrane zone was noted, and granular deposits of IgM were present in small vessels of dermal papillae. The mouth ulcerations healed promptly after withdrawal of the drug, whereas the macules persisted for some months. The immunohistochemical findings indicated that the drug eruptions were related to a vasculitis induced by deposition of immune complexes.

Detection of T-lymphocyte subpopulation in the peripheral blood and the synovium of patients with rheumatoid arthritis and juvenile rheumatoid arthritis using monoclonal antibodies

Monoclonal antibodies with specificities for various human T-cell antigens were used in direct immunofluorescence to quantify the proportions of T lymphocytes with suppressor/cytotoxic-cell markers and with helper/inducer-cell markers and of T lymphocytes with HLA-DR antigens. Normal percentages of lymphocytes with suppressor/cytotoxic-cell markers were detected in the peripheral blood synovial fluid and synovial tissue lymphocytes from patients with juvenile rheumatoid arthritis (JRA) and rheumatoid arthritis (RA), respectively. Normal percentages of T lymphocytes with helper/inducer-cell markers were seen in the peripheral blood of RA and JRA patients and in the synovial tissues of RA patients. Slightly decreased percentages of cells with the helper/inducer-cell marker were detected in the synovial fluids of JRA patients. The proportions of HLA-DR-positive T lymphocytes were highly increased in the synovial fluid and synovial tissue, whereas the numbers of these cells in the peripheral blood were normal. No significant differences in T gamma cells were detected between peripheral blood, synovial fluid and synovial tissue of JRA patients or between peripheral blood and synovial tissue of RA patients.

Inflammatory synovial tissue mononuclear cells release leucocyte migration inhibition factor in antigen- and mitogen-free cultures

The presence of leucocyte migration inhibition factor (LIF) in supernatants from apparently antigen- and mitogen-free cultures of mononuclear cells (MNC) was studied. MNC were eluted from inflamed synovial tissue or isolated from blood. Untreated supernatants, supernatants in which any LIF had been inactivated, and culture medium were compared in their ability to affect the migration of homologous polymorphonuclear leucocytes. LIF was released by synovial tissue MNC from all of the 9 patients studied, consisting of 5 patients with rheumatoid arthritis, 2 with psoriatic arthropathy, and 2 with juvenile rheumatoid arthritis. Blood MNC of the patients and of 8 healthy blood donors did not release LIF. When synovial tissue MNC supernatants from 2 patients were examined, LIF activity increased as time of incubation was extended. In at least 2 synovial tissue MNC supernatants in which LIF had been inactivated a migration enhancement activity was revealed.