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a Department of Rheumatology, Zuider Ziekenhuis,
Rotterdam, the Netherlands, b Department of
Auto Immune Diseases, Central Laboratory Red Cross
Bloodtransfusion Service, Amsterdam, the Netherlands
Correspondence to: Dr A J G Swaak, Zuiderziekenhuis, Department of Rheumatology, Groene Hilledijk 315, Rotterdam, the Netherlands.
Accepted for publication 10 September 1997
OBJECTIVE
The measurement of cytokine production
of activated lymphocytes and monocytes in the whole blood cell (WBC)
culture system may provide a sensitive tool for evaluating
the actual ongoing immune response of patients with rheumatoid
arthritis (RA).
METHODSLipopolysaccharide (LPS) up to 250 pg/ml
was used for the stimulation of monocytes for measuring the
production of tumour necrosis factor 
(TNF), interleukin 6 (IL6)
and IL12, while the anti-CD3 (1 µg/ml) and anti-CD28 (5 µg/ml)
combination was used for T cell stimulation with the measuring
of IL4 and interferon gamma (INF
) production. Twenty seven patients
with RA and 23 healthy controls were studied.
RESULTSThe results showed a decreased IL6
(LPS stimulus 4-6 pg/ml) and IL12 (LPS stimulus 16-62 pg/ml)
production in the RA patients. The maximal production of both
cytokines was comparable with the normal controls. T cell
stimulation showed a significant decreased INF
production in the RA patients.
CONCLUSIONSThese findings obtained in the WBC
culture system are highly suggestive for a decreased TH-1 derived
cytokine production by a diminished IL12 production in RA
patients. Another possibility is that both IL12 and INF
production in WBCs are inhibited by eventual circulating serum factors.
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