An association between the acute phase response and patterns of antigen induced T cell proliferation in juvenile idiopathic arthritis
1 Department of Rheumatology, Division of Immunity and Infection, University of Birmingham, Birmingham, UK
2 Current address: MRC Human Immunology Unit, Institute of Molecular Medicine, Oxford, UK
3 Birmingham Children's Hospital, Birmingham, UK
4 Department of Rheumatology, Birmingham Heartlands and Solihull Hospitals – NHS Trust (Teaching), Birmingham, UK
Arthritis Res Ther 2003, 5:R277-R284 doi:10.1186/ar791Published: 7 July 2003
The aim of this research was to determine whether all memory T cells have the same propensity to migrate to the joint in patients with juvenile idiopathic arthritis. Paired synovial fluid and peripheral blood mononuclear cell proliferative responses to a panel of antigens were measured and the results correlated with a detailed set of laboratory and clinical data from 39 patients with juvenile idiopathic arthritis. Two distinct patterns of proliferative response were found in the majority of patients: a diverse pattern, in which synovial fluid responses were greater than peripheral blood responses for all antigens tested; and a restricted pattern, in which peripheral blood responses to some antigens were more vigorous than those in the synovial fluid compartment. The diverse pattern was generally found in patients with a high acute phase response, whereas patients without elevated acute phase proteins were more likely to demonstrate a restricted pattern. We propose that an association between the synovial fluid T cell repertoire and the acute phase response suggests that proinflammatory cytokines may influence recruitment of memory T cells to an inflammatory site, independent of their antigen specificity. Additionally, increased responses to enteric bacteria and the presence of αEβ7 T cells in synovial fluid may reflect accumulation of gut associated T cells in the synovial compartment, even in the absence of an elevated acute phase response. This is the first report of an association between the acute phase response and the T cell population recruited to an inflammatory site.