Monocytes from patients with rheumatoid arthritis (RA), osteoarthritis (OA), and normal volunteers were studied for abnormalities of Fc and C3 receptor function. Monocytes from the majority of 22 patients with active RA showed enhanced EA-rosette formation and EA phagocytosis compared to monocytes from 20 normal volunteers and 10 OA patients. However, no significant differences in binding of EAC or uptake of iodinated aggregated gamma globulin were found among the 3 groups. Corticosteroid-treated RA patients exhibited significant depression of EA-rosette formation and phagocytosis. These results suggest that there is modulation of EA receptor function in monocytes from RA patients.The role and function of cells of the mononuclear phagocyte system in patients with rheumatic diseases has not been clarified. Decreased activity of splenic macrophages in clearing antigen-antibody complexes in patients with systemic lupus erythematosus (SLE) complexes in the circulation, and thereby, continued inflhmation (1,2). Peripheral blood monocytes share certain common properties, including the presence of Fc and C3b receptors, with other cells of the mononuclear phagocyte system (3). In addition, monocytes represent precursor cells to tissue macrophages and are easily available for investigation. Studies in RA have suggested that monocyte function is normal (4) or that increased phagocytosis and metabolic activity may be present (5,6). In the present study, monocytes from patients with RA were examined for alterations in Fc and C3b receptor function.
MATERIALS AND METHODSPatients. Twenty-two hospitalized patients with classic or definite RA (7) were studied. Only patients whose disease was considered active with increased synovitis or involvement of new joints and who had been hospitalized because of worsening of clinical status were included. Blood was also obtained from 20 normal volunteers of similar age and sex. In addition, blood was obtained from 10 patients with osteoarthritis (OA).Separation of monocytes. Mononuclear cells were obtained from heparinized blood by density gradient centrifugation on Ficoll-Hypaque (8), at a density of 1.080glcc. After centrifugation (6OOg for 30 minutes at 2VC, the mononuclear cell layer was washed 3 times in fresh RPMI 1640 (Microbiological Associates, Walkersville, MD) at 2508 for 10 minutes, and resuspended in RPMI 1640 and 10% heat inactivated pooled human sera from nontransfused males. The mononuclear cell preparation at this point contained 80-90% lymphocytes and 10-20% monocytes with less than I% polymorphonuclear leukocytes as assessed by Wright stain, peroxidase stain (9), and Euchrysine staining (10). The mononuclear cell preparation was adjusted to a final concentration of 5 million cellslml in RPMI 1640 + 10% heat inactivated sera, and 0.2 ml was layered in a bubble onto