Immunoregulatory changes in autoimmune disease.

Peripheral blood T cell subpopulations were determined in patients with various rheumatic diseases [rheumatoid arthritis (RA); ankylosing spondylitis (AS); reactive synovitis (RS)]. No significant variation in OKT3+ cells was found among these groups. In RA, an increased percentage of OKT4+ was found in relation to the control group. For the other groups no difference was observed. In RA, a decreased percentage of OKT8+ cells was observed. Thus, the immunologic imbalance found in RA was not encountered in AS and RS although these disease--as well as the other pathologic disorders--are characterized by serum hypergammaglobulinemia. Furthermore, the decreased number of T suppressor cells found in peripheral blood of patients with active RA was not observed in their synovial fluid. Therefore we propose a failure of localization mechanism of T suppressor-cytotoxic lymphocytes in the synovial membrane of RA. Single doses of prednisolone produced a temporary decrease in peripheral blood total lymphocytes, T cells, T helper-inducer cells, and a less marked decrease in T suppressor-cytotoxic cells, in effect, a normalization of the immune balance, characterized by a decreased T helper/T suppressor ratio. In a similar fashion, patients receiving long-term levamisole exhibited a decrease in total lymphocytes, T lymphocytes, T helper cells, and T suppressor cells 6 and 24 hr after drug intake with a subsequent normalization of the OKT4+/OKT8+ ratio.