Immunologic studies of rheumatoid arthritis patients treated with methotrexate.
Immunologic studies of rheumatoid arthritis patients treated with methotrexate.
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接受甲氨蝶呤治疗的类风湿性关节炎患者的免疫学研究。
DOI：
10.1002/art.1780300501
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发表时间：
1987
影响因子：
--
通讯作者：
Pincus,T
中科院分区：
文献类型：
--
作者：
Olsen,NJ;Callahan,LF;Pincus,T
本文研究了甲氨蝶呤（MTX）治疗类风湿关节炎（RA）患者外周血单个核细胞的免疫功能。在18例MTX治疗的患者中，只有3例未受刺激的培养血液单核细胞自发合成IgM类风湿因子（IgM-RF），而54例未接受长效药物的RA患者中有31例。MTX治疗的患者中，未刺激的培养单核细胞的总IgM产生、美洲商陆丝裂原诱导的抗体合成和血浆IgM-RF水平也低于其他RA患者。MTX治疗组和非MTX治疗组患者的循环B细胞、T4和T8细胞数量、T4：T8细胞比例和有丝分裂原诱导增殖指数相似。在开始MTX治疗后，对另外11例患者进行了前瞻性研究。所有患者均显示自发性IgM-RF合成显著减少，IgM-RF：IgM比值下降，包括在治疗前24小时内研究的所有9例患者。结果表明，MTX对IgM‐RF合成具有快速作用，这种作用可能与其在RA中的治疗效果有关。
Immunologic functions of peripheral blood mononuclear cells were studied in rheumatoid arthritis (RA) patients treated with methotrexate (MTX). Spontaneous IgM rheumatoid factor (IgM‐RF) synthesis by unstimulated cultured blood mononuclear cells was seen in only 3 of 18 MTX‐treated patients, compared with 31 of 54 RA patients who were not receiving long‐acting drugs. Total IgM production by unstimulated cultured mononuclear cells, pokeweed mitogen‐induced antibody synthesis, and plasma levels of IgM‐RF were also lower in MTX‐treated patients than in other RA patients. The numbers of circulating B cells, T4 and T8 cells, the T4:T8 cell ratio, and mitogen‐induced proliferation indices were similar in MTX‐treated and non‐MTX‐treated patients. Eleven additional patients were studied prospectively after initiation of MTX therapy. All showed significant decreases in spontaneous IgM‐RF synthesis, with declining IgM‐RF:IgM ratios, including all of the 9 who were studied during the first 24 hours of treatment. The results indicate that MTX has rapid effects on IgM‐RF synthesis, and this action might be associated with its therapeutic efficacy in RA.