Synovial fluid lymphocytes in rheumatoid arthritis

Abstract

There is significant evidence implicating immunologic mechanisms in the pathogenesis of rheumatoid arthritis (RA). To investigate the possibility that a cellular imbalance of T and B lymphocytes plays a role in perpetuating synovitis, an examination of the peripheral blood and synovial fluid lymphocytes of patients with seropositive rheumatoid arthritis was undertaken. A significant lymphopenia was encountered in RA patients, with values approximately midway between those in normal controls and the severe lymphopenia seen in a group of patients with systemic lupus erythematosus. A significantly greater diminution of T than B cells was noted in RA, and normal percentage distributions of lymphocytes in peripheral blood were documented. Normal percentages of T and B cells, similar to those in peripheral blood, were found in synovial fluids of patients with seropositive RA, seronegative RA, osteoarthritis, and gout. Two seropositive patients ex-

Lymphocytes in rheumatoid and nonrheumatoid synovial fluids: Nonspecificity of high T-cell and low B-cell percentages

“…In the peripheral blood the absolute number of lymphocytes was decreased in groups I and II (RA and other polyarthritides) compared with the control values. This finding agrees with a recent report by Utsinger (1975). We were unable to show a correlation between absolute numbers of T lymphocytes and complement activity in the synovial fluid as reported by others (Winchester and others, 1973).…”

“…Brenner and others (1975), who investigated synovial fluid T and B lymphocytes in diseases comparable with our group II, found different proportions of these cells in their individual patient groups. On the other hand, Utsinger (1975) recently studied a wide variety of arthritides including RA, osteoarthrosis, and gout, and was unable to show any difference between the percentages of T-and B-cells in the synovial fluids, and also found the same pattern of T-and B-cell percentages in the peripheral blood and synovial fluids of all of the groups he investigated.…”

“…However, other authors have reported different results, i.e. decreased (Winchester and others, 1974) or equal (Utsinger, 1975) percentages of T-cells and increased (Mellbye and others, 1972) or equal (Vernon-Roberts and others, 1974;Brenner and others, 1975;Utsinger, 1975) percentages of B-cells in synovial fluids as compared with peripheral blood. Very few data on lymphocytes in nonrheumatoid synovial fluids are available.…”

“…It is possible that the underlying pathogenetic mechanisms can be elucidated by studying lymphocytes, which play a major role in immune response. The relative proportions of T and B lymphocytes in synovial fluid and peripheral blood have recently been studied in RA (Mellbye and others, 1972;Fr0land, Natvig, and Husby, 1973;Vernon-Roberts, Currey, and Perrin, 1974;Sheldon, Papamichail, and Holborow, 1974;Winchester and others, 1974;Brenner, Scheinberg, and Cathcart, 1975;Utsinger, 1975) and also in other joint diseases (Fr0land and others, 1973;Brenner and others, 1975;Utsinger, 1975). These studies disagree in several respects, however.…”

Immunological and Functional Characteristics of Peripheral Blood and Synovial Fluid Lymphocytes from Patients with Rheumatoid Arthritis

“…Several investigators (5,31,37,45,54] studied the distribution of T-and B-cells. but there has been no general agreement on the comparison between rheumatoid and normal PBL nor between rheumatoid PBL and SFL.…”