The clinical and immunological effects of pulse methylprednisolone therapy in rheumatoid arthritis. III. Effects on immune and inflammatory indices in synovial fluid.

Pulse methylprednisolone therapy has dramatic effects on cellular traffic and immunological variables of disease activity in both the synovial fluid (SF) and peripheral blood compartments. While these effects persisted at 2 weeks in the SF they had reverted to pretreatment levels in the peripheral blood. Pulse therapy resulted in temporary changes in the number of helper and suppressor cells in peripheral blood with an initial fall followed by a rise in the helper to suppressor ratio. In the SF, pulse therapy produced more gradual and sustained effects on the helper and suppressor subpopulations, resulting in a reduction in the helper to suppressor ratio.