Methods. Peripheral blood mononuclear cells (PBMCs) from RA patients (n=19) were labeled with CFSE [5 (and 6) carboxyfluorescein diacetate, succinimidyl ester] and cultured with ConA. CD4+ T cells were assessed for production of IFN-gamma, IL-4 and TNF-alpha, and proliferation by flow cytometry. We examined association of these parameters with clinical response of TNF-alpha blockers in short, medium and long term studies.
Results: Clinical good response of TNF-alpha blockers was associated with lower TNF-alpha production in proliferating CD4+ T cells in short term study (p<0.05). Increased production of IFN-gamma (p<0.05) in proliferating CD4+ T cells was associated with good response in long term study.
Conclusions: In vitro evaluation of cytokine production in proliferating CD4+ T cells, prior to treatment of TNF-alpha blockers, may provide possible information of efficacy of TNF-alpha blockers in RA patients.