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T Cell Proliferative Response to Type II Collagen in the Inflammatory Process and Joint Damage in Patients with Rheumatoid Arthritis
WAN-UK KIM and KI-JUN KIM
ABSTRACT. Methods. T cell proliferative responses to bovine CII by peripheral blood mononuclear cells (PBMC) from patients with early RA (duration < 5 yrs) were assayed by mixed lymphocyte culture. Clinical and laboratory variables including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were examined at the time of sampling. Radiographic damage on hand radiographs was evaluated by the method of Steinbrocker and Sharp. Results. In a cross sectional study, patients (n = 22) with positive T cell responses (stimulation index ≥ 2) had higher levels of CRP and ESR than those (n = 21) not showing T cell responses. The number of damaged joints (by Steinbrocker's method) and damaged joint scores (by Sharp's method) were significantly higher in patients with positive T cell responses than in those without. The joint space narrowing scores correlated well with T cell responsiveness to CII. Patients (n = 15) with both positive T cell responses and RA-susceptible allotypes HLA-DR1 or DR4 had higher damaged joint scores than the remainder of the patients (n = 24). Conclusion. T cell proliferative responses to CII are associated with inflammatory activity and radiographic severity in RA. RA-susceptible allotypes positively relate to the radiographic progression associated with T cell responses to CII. Our data suggest that CII-reactive T cells may play a role in the pathogenic process of joint damage, especially in genetically susceptible patients. (J Rheumatol 2005;32:225-30) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Division of Rheumatology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, St. Vincent's Hospital, Suwon; and Department of Radiology, Our Lady of Mercy Hospital, Incheon, South Korea. Supported by a grant from the Catholic Research Institutes of Medical Science. W-U. Kim, MD, Division of Rheumatology, Department of Internal Medicine, School of Medicine, Catholic University of Korea; K-J. Kim, MD, Department of Radiology, Our Lady of Mercy Hospital. Address reprint requests to Dr. W-U. Kim, Division of Rheumatology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, St. Vincent's Hospital, 93 Chi-Dong, Suwon 442-060, South Korea. E-mail: wan725@catholic.ac.kr Submitted December 29, 2003; revision accepted June 9, 2004. |