concanavalin-a and Rheumatic-Diseases

To investigate whether activity and glucocorticoid treatment of rheumatic diseases are reflected by selected parameters of cellular energy metabolism of peripheral blood mononuclear cells (PBMC).. PBMC were obtained from 30 healthy volunteers, 28 patients (16 inactive; 12 active) with rheumatoid arthritis, systemic lupus erythematosus, vasculitis, or other autoimmune diseases, and five patients with infectious diseases. Patients with active rheumatic diseases were examined before and 4-5 days after starting, restarting, or increasing the dose of glucocorticoids. Cellular oxygen consumption (as a measure of ATP production), bioenergetic ability to be stimulated, and major ATP consuming processes were measured amperometrically with a Clark electrode.. A normal value for oxygen consumption of 3.84 (SEM 0.1) (all data in nmol O(2)/min/10(7) cells) independent of sex was found. In patients with inactive disease the respiration rate was slightly higher, but was significantly increased in active patients to 4.82 (SEM 0.33) (p<0.001). PBMC from active patients showed a significantly lower bioenergetic response to a mitogenic stimulus than controls (p<0.05). In stimulated cells from active patients there was a significant reduction in cation transport and protein synthesis. All parameters above were almost normalised within 4-5 days upon optimised treatment with glucocorticoids. For comparison, PBMC from patients with active infectious diseases also showed an increased respiration rate; their response to mitogenic stimulation was even higher.. This study shows for the first time that parameters describing the cellular function of PBMC in bioenergetic terms are suitable for (a) describing semiquantitatively the activity of a rheumatic disease and (b) assessing the therapeutic effect on the disease.

Topics: Adolescent; Adult; Aged; Antirheumatic Agents; Autoimmune Diseases; Cell Culture Techniques; Concanavalin A; Energy Metabolism; Female; Glucocorticoids; Humans; Leukocytes, Mononuclear; Male; Middle Aged; Oxygen Consumption; Rheumatic Diseases; Treatment Outcome; Virus Diseases

We investigated serum levels of interleukin-6 (IL-6), interferon-gamma (IFN-gamma), and tumor necrosis factor alpha (TNF alpha) from patients with systemic lupus erythematosus (SLE) and its various clinical manifestations of disease and from patients with rheumatoid arthritis (RA) and other rheumatic diseases. The serum levels of IL-6 and IFN-gamma were highly elevated from patients with SLE associated with lymphadenopathy (LN) or nephrotic syndrome (NS). On the contrary, the serum levels of TNF alpha were elevated from most patients with SLE associated with thrombocytopenia (TP). However, serum levels of TNF alpha were in the normal range from patients with SLE associated with NS, LN, or central nervous system disease. Of interest, patients with SLE associated with humoral immunodeficiency disorder, hypogammaglobulinemia, had highly elevated levels of serum IL-6. The concanavalin A-stimulated mononuclear cells (MNC) of patients with SLE associated with TP secreted highly elevated levels of TNF alpha compared to other patient groups. We suggest that abnormal production of various cytokines in SLE is an intrinsic defect of MNC and the immune system that may be the key element for a variety of clinical manifestations of this disease.

Topics: Adolescent; Adult; Arthritis, Rheumatoid; Behcet Syndrome; Concanavalin A; Cytokines; Female; Humans; Interferon-gamma; Interleukin-6; Lupus Erythematosus, Systemic; Lymphadenitis; Male; Middle Aged; Nephrotic Syndrome; Polymyalgia Rheumatica; Rheumatic Diseases; Sjogren's Syndrome; Thrombocytopenia; Tumor Necrosis Factor-alpha

Topics: Arthritis, Rheumatoid; C-Reactive Protein; Carbohydrates; Concanavalin A; Genetic Variation; Humans; Immunoelectrophoresis; Lupus Erythematosus, Systemic; Orosomucoid; Rheumatic Diseases; Spondylitis, Ankylosing