We evaluated 257 patients with rheumatoid arthritis (RA) to determine the frequency of circulating immune complexes (CIC) in the serum, relationships between the presence of CIC, clinical indices of disease activity and other laboratory features, and relationships between changes in CIC levels and changes in disease activity. CIC were detected by fluid phase Clq binding activity, conglutinin binding activity, anti-C3 assay, staphylococci protein A binding assay and the precipitation of cryoglobulins. CIC in the serum were found to correlate with indices of disease activity, extraarticular features and the presence of rheumatoid factor. A change in Clq binding activity correlated with a parallel change in the joint count.
Phenotypic analysis of circulating lymphocytes and T cell subsets using monoclonal antibodies was performed on 60 patients with rheumatoid arthritis (RA). A significant lymphopenia was observed in RA patients and correlated with the use of disease suppressant drugs (p less than 0.0001). A significant decrease in the number of suppressor/cytotoxic T cells resulted in an increase in the TH/TS ratio in 40% of RA patients. This elevated ratio did not correlate with disease activity, the presence of extraarticular features, autoantibody production or immune complex formation. We conclude that the evaluation of the TH/TS ratio has no diagnostic or prognostic value.
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