Sulphasalazine Therapy in Rheumatoid Arthritis: Qualitative Changes in Lymphocytes and Correlation With Clinical Response

Abstract

Clinical and immunological parameters in 14 patients with rheumatoid arthritis (RA) receiving sulphasalazine (SASP) were evaluated, to determine whether their clinical response was reflected by any quantitative changes in their peripheral blood lymphocytes after 12 weeks. Whilst disease activity markers fell significantly, no such changes were noted in the percentage or absolute numbers of lymphocytes or their subsets. The lymphocytes of a further 21 patients before and after receiving SASP for 12 weeks were then studied qualitatively. The suppression mediated by in vitro SASP on ex vivo PHA stimulated lymphocytes showed a decrease at 12 weeks. This change was more marked and reached statistical significance only in those patients who showed a good clinical response. It is postulated that this may in some way be related to expression of activation markers and concomitant SASP binding.

Evidence for differential effects of sulphasalazine on systemic and mucosal immunity in rheumatoid arthritis.

“…Reductions in none, one, two or all three of the IgA, IgG, or IgM classes have been reported3 [49][50][51][52][53][54][55][56][57][58][59][60][61][62] Six of our patients had increased serum IgA anti-gliadin antibody levels. The serum levels of IgA anti-gliadin antibodies decreased significantly during SASP therapy.…”