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Panminerva Medica 2000 December;42(4):263-6

lingua: Inglese

Impaired cutaneous cell-mediated immunity in newly diagnosed rheumatoid arthritis

Coaccioli S., Di Cato L., Marioli D., Patucchi E., Pizzuti C., Ponteggia M., Puxeddu A.

From the Department of Internal Medicine and Rheumatology Unit Perugia University School of Medicine “Santa Maria” Hospital, Terni, Italy


Background. Rheumatoid ­arthritis is char­ac­ter­ized by an ­impaired ­immune ­response and a defec­tive cuta­ne­ous ­cell-medi­at­ed immu­nity has ­been report­ed. This ­study was real­ised in ­order to deter­mine the char­ac­ter­is­tics of cuta­ne­ous ­cell-medi­at­ed immu­nity in ­patients affect­ed by ­recent-­onset and untreat­ed rheu­ma­toid ­arthritis.
Methods. Forty-­enght ­patients affect­ed by new­ly diag­nosed rheu­ma­toid ­arthritis ­were stud­ied by ­skin test­ing ­with sev­en com­mon ­recall anti­gens. The ­skin ­tests ­were per­formed ­before the admin­is­tra­tion of dis­ease mod­i­fy­ing ­anti-rheu­mat­ic ­drugs (methot­rex­ate, cyclo­spo­rine-A, hydrox­ych­lor­o­quine) and ­were repeat­ed ­after ­four ­months of ther­a­py.
Results. 43.75% of the RA ­patients (21 out of 48) ­were ­defined as aner­gic com­pared ­with 2% of the nor­mal con­trol sub­jects and the ­rate of depres­sion of cuta­ne­ous ­cell-medi­at­ed immu­nity was not relat­ed ­either ­with the mark­ers of dis­ease activ­ity or ­with the clin­i­cal assess­ment. The ­impaired cuta­ne­ous ­cell-medi­at­ed immu­nity ­shows a ­slight improve­ment ­after methot­rex­ate ther­a­py, ­while cyclo­spo­rine-A and hydrox­ych­lor­o­quine ­were not ­able to ­achieve the ­same ­result.
Conclusions. Rheumatoid ­arthritis ­shows a defec­tive cuta­ne­ous ­cell-medi­at­ed immu­nity ­when the ­patients are stud­ied in the ear­ly ­phase of the dis­ease and ­before a sec­ond-­line of ther­a­py ­with dis­ease mod­i­fy­ing anti­-rheu­mat­ic ­drugs. The aner­gy ­does not cor­re­late ­either ­with the dis­ease activ­ity or ­with the ­short-­term ­response to treat­ment. The prog­nos­tic sig­nif­i­cance of ­these ­data ­remains uncer­tain.

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