Increase in TCR gamma delta T lymphocytes in synovia from rheumatoid arthritis patients with active synovitis.

To determine the relative presence of TCR gamma delta+ and TCR alpha beta+ T cells in synovial tissue from patients with various types of inflammatory synovitis and in tissues from patients with a number of chronic T cell-mediated conditions, we stained frozen tissue sections with monoclonal antibodies in indirect immunofluorescence assays. In tissues obtained from patients with chronic T cell-mediated granulomatous conditions (Wegener's granulomatosis, lymphomatoid granulomatosis, granuloma annulare, Langerhans' cells granulomatosis, pigmented villonodular synovitis, Takayasu's arteritis, and talc granulomatosis), the T cells present were predominantly TCR alpha beta+, without an increased presence of TCR gamma delta+ cells. In contrast, 6 of 14 (43%) synovia from patients with rheumatoid arthritis (RA) showed increased TCR gamma delta+ T cells (3-10 cells/hpf). The RA synovia with increased TCR gamma delta+ cells present had an increased tissue inflammation score compared to RA synovia with few TCR gamma delta+ cells [18.6 +/- 5.8 versus 11.6 +/- 4.2 (mean +/- SE), P less than 0.05]. In contrast, synovia from patients with osteoarthritis, systemic lupus erythematosus, and trauma did not show an increased presence of TCR gamma delta+ T cells. Thus, in cellular inflammatory infiltrates the presence of increased TCR gamma delta cells is not a component of noninfectious granulomatous inflammation but is found in approximately 40% of RA synovia with high levels of inflammation.