Role of peripheral CD8 lymphocytes and soluble IL-2 receptor in predicting the duration of corticosteroid treatment in polymyalgia rheumatica and giant cell arteritis

Carlo Salvarani, Luigi Boiardi, Pierluigi MacChioni, Fulvia Rossi, Pierluigi Tartoni, Mario Casadei Maldini, Rita Mancini, Elisabetta Beltrandi, Italo Portioli

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Abstract

Objectives-To determine if the presence of low percentages of CD8 positive cells or high levels of soluble interleukin-2 receptors (sIL-2R) define a subgroup of patients with more severe polymyalgia rheumatica and giant cell arteritis (PMR/GCA). Methods-38 PMR/GCA patients were followed up prospectively. Serum levels of sIL-2R and peripheral blood CD8 lymphocytes were measured before the start of corticosteroid treatment, after six months of treatment and at the last visit. Phenotypical analysis of lymphocyte subpopulations was performed with a two colour technique, and assay of sIL-2R was performed using an enzyme-linked immunosorbent kit. Forty four healthy people matched for age and gender comprised a healthy control group. Results-The median duration of follow up was 28 months (range 7-65). Corticosteroid treatment lasted a median of 23-5 months (7-65). Eleven patients (29%) were in remission at the end of follow up; 45% of the patients had at least one relapse or recurrence. Compared with controls, patients with active disease had a significantly lower percentage ofCD8 cells and significantly increased sIL-2R levels. Erythrocyte sedimentation rate, C reactive protein, and sIL-2R values were significantly less after six months of steroid treatment compared with before treatment. The percentage of CD8 cells remained significantly lower at six months and the end of follow up compared with controls, while sIL-2R levels remained significantly greater. Patients in whom the percentage ofCD8 cells at six months was lower than one SD of the mean of normal controls (26%) had a significantly longer duration of corticosteroid treatment, a greater cumulative dose ofprednisone and more relapses or recurrences compared with patients in whom the percentage was in the normal range. The duration of treatment and the cumulative dose of prednisone were not influenced by the percentage of CD8 cells before treatment therapy or by the levels of sIL-2R after six months oftreatment. Conclusions-A reduced percentage of CD8 cells after six months of treatment may be a useful outcome parameter which would identify a group of PMR/GCA patients likely to experience more severe disease, defined as longer duration of corticosteroid treatnent, higher cumulative dose of prednisone, and relapse or recurrence of disease.

Original languageEnglish
Pages (from-to)640-644
Number of pages5
JournalAnnals of the Rheumatic Diseases
Volume54
Issue number8
DOIs
Publication statusPublished - 1995

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Polymyalgia Rheumatica
Giant Cell Arteritis
Lymphocytes
Interleukin-2 Receptors
Adrenal Cortex Hormones
Recurrence
Prednisone
Therapeutics
Immunosorbents
Sedimentation
C-Reactive Protein
Assays
Blood
Blood Sedimentation
Lymphocyte Subsets
Steroids
Cells
Color
Reference Values
Enzymes

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Immunology
  • Rheumatology

Cite this

Role of peripheral CD8 lymphocytes and soluble IL-2 receptor in predicting the duration of corticosteroid treatment in polymyalgia rheumatica and giant cell arteritis. / Salvarani, Carlo; Boiardi, Luigi; MacChioni, Pierluigi; Rossi, Fulvia; Tartoni, Pierluigi; Maldini, Mario Casadei; Mancini, Rita; Beltrandi, Elisabetta; Portioli, Italo.

In: Annals of the Rheumatic Diseases, Vol. 54, No. 8, 1995, p. 640-644.

Research output: Contribution to journalArticle

Salvarani, Carlo ; Boiardi, Luigi ; MacChioni, Pierluigi ; Rossi, Fulvia ; Tartoni, Pierluigi ; Maldini, Mario Casadei ; Mancini, Rita ; Beltrandi, Elisabetta ; Portioli, Italo. / Role of peripheral CD8 lymphocytes and soluble IL-2 receptor in predicting the duration of corticosteroid treatment in polymyalgia rheumatica and giant cell arteritis. In: Annals of the Rheumatic Diseases. 1995 ; Vol. 54, No. 8. pp. 640-644.
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abstract = "Objectives-To determine if the presence of low percentages of CD8 positive cells or high levels of soluble interleukin-2 receptors (sIL-2R) define a subgroup of patients with more severe polymyalgia rheumatica and giant cell arteritis (PMR/GCA). Methods-38 PMR/GCA patients were followed up prospectively. Serum levels of sIL-2R and peripheral blood CD8 lymphocytes were measured before the start of corticosteroid treatment, after six months of treatment and at the last visit. Phenotypical analysis of lymphocyte subpopulations was performed with a two colour technique, and assay of sIL-2R was performed using an enzyme-linked immunosorbent kit. Forty four healthy people matched for age and gender comprised a healthy control group. Results-The median duration of follow up was 28 months (range 7-65). Corticosteroid treatment lasted a median of 23-5 months (7-65). Eleven patients (29{\%}) were in remission at the end of follow up; 45{\%} of the patients had at least one relapse or recurrence. Compared with controls, patients with active disease had a significantly lower percentage ofCD8 cells and significantly increased sIL-2R levels. Erythrocyte sedimentation rate, C reactive protein, and sIL-2R values were significantly less after six months of steroid treatment compared with before treatment. The percentage of CD8 cells remained significantly lower at six months and the end of follow up compared with controls, while sIL-2R levels remained significantly greater. Patients in whom the percentage ofCD8 cells at six months was lower than one SD of the mean of normal controls (26{\%}) had a significantly longer duration of corticosteroid treatment, a greater cumulative dose ofprednisone and more relapses or recurrences compared with patients in whom the percentage was in the normal range. The duration of treatment and the cumulative dose of prednisone were not influenced by the percentage of CD8 cells before treatment therapy or by the levels of sIL-2R after six months oftreatment. Conclusions-A reduced percentage of CD8 cells after six months of treatment may be a useful outcome parameter which would identify a group of PMR/GCA patients likely to experience more severe disease, defined as longer duration of corticosteroid treatnent, higher cumulative dose of prednisone, and relapse or recurrence of disease.",
author = "Carlo Salvarani and Luigi Boiardi and Pierluigi MacChioni and Fulvia Rossi and Pierluigi Tartoni and Maldini, {Mario Casadei} and Rita Mancini and Elisabetta Beltrandi and Italo Portioli",
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T1 - Role of peripheral CD8 lymphocytes and soluble IL-2 receptor in predicting the duration of corticosteroid treatment in polymyalgia rheumatica and giant cell arteritis

AU - Salvarani, Carlo

AU - Boiardi, Luigi

AU - MacChioni, Pierluigi

AU - Rossi, Fulvia

AU - Tartoni, Pierluigi

AU - Maldini, Mario Casadei

AU - Mancini, Rita

AU - Beltrandi, Elisabetta

AU - Portioli, Italo

PY - 1995

Y1 - 1995

N2 - Objectives-To determine if the presence of low percentages of CD8 positive cells or high levels of soluble interleukin-2 receptors (sIL-2R) define a subgroup of patients with more severe polymyalgia rheumatica and giant cell arteritis (PMR/GCA). Methods-38 PMR/GCA patients were followed up prospectively. Serum levels of sIL-2R and peripheral blood CD8 lymphocytes were measured before the start of corticosteroid treatment, after six months of treatment and at the last visit. Phenotypical analysis of lymphocyte subpopulations was performed with a two colour technique, and assay of sIL-2R was performed using an enzyme-linked immunosorbent kit. Forty four healthy people matched for age and gender comprised a healthy control group. Results-The median duration of follow up was 28 months (range 7-65). Corticosteroid treatment lasted a median of 23-5 months (7-65). Eleven patients (29%) were in remission at the end of follow up; 45% of the patients had at least one relapse or recurrence. Compared with controls, patients with active disease had a significantly lower percentage ofCD8 cells and significantly increased sIL-2R levels. Erythrocyte sedimentation rate, C reactive protein, and sIL-2R values were significantly less after six months of steroid treatment compared with before treatment. The percentage of CD8 cells remained significantly lower at six months and the end of follow up compared with controls, while sIL-2R levels remained significantly greater. Patients in whom the percentage ofCD8 cells at six months was lower than one SD of the mean of normal controls (26%) had a significantly longer duration of corticosteroid treatment, a greater cumulative dose ofprednisone and more relapses or recurrences compared with patients in whom the percentage was in the normal range. The duration of treatment and the cumulative dose of prednisone were not influenced by the percentage of CD8 cells before treatment therapy or by the levels of sIL-2R after six months oftreatment. Conclusions-A reduced percentage of CD8 cells after six months of treatment may be a useful outcome parameter which would identify a group of PMR/GCA patients likely to experience more severe disease, defined as longer duration of corticosteroid treatnent, higher cumulative dose of prednisone, and relapse or recurrence of disease.

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