Failure of cytotoxic drugs to suppress immune responses of patients with rheumatoid arthritis.

Immunologic reactivity in rheumatoid arthritis response to mitogens

“…Comparing reactivity between different immunopathic conditions showed that depressed responses were most marked for chronic active hepatitis, less marked in systemic lupus erythematosus and least affected in rheumatoid arthritis. Denman et al (13) studied the immunologic performance of two groups of patients with rheumatoid arthritis, comparing these responses to normal volunteer controls. The patients with rheumatoid arthritis included those whose disease was severe enough to be treated with cytotoxic drugs, and a group of patients with less severe manifestations.…”

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“…They commented only that this minority did not correlate with those patients who had decreased skin test reactivity to common antigens, which was the subject of major interest in their investigation. Denman et a1 (9) found that a group of rheumatoids selected for immunosuppressive therapy had lower PHA responses than those selected for treatment without immunosuppressive therapy. They made no further comment on this difference.…”

“…Some investigators (1-5) have reported no significant differences between rheumatoids and controls. Others (6)(7)(8)(9) have noted some very low responses among rheumatoids but have reported normal mean values. Still others (10)(11)(12) have reported generally low responses in rheumatoids.…”

Skin tests with influenza virus

“…The specificity of the reactions shows that they are due to a particular viral component, but further work is necessary to determine whether they can be produced by pure haemagglutinin or other peptides extracted from virus particles. In addition, the mechanism of the reaction should be studied; for example, by looking for specific transformation of lymphocytes with virus antigen, as was done in a different context by Denman et al (1970). This approach would make it possible to look for blocking antibodies, the presence of which might account for the existence of at least some of those subjects who have clearly been exposed to virus because they have serum antibody and who resist reinfection but who have negative skin reactions.…”