Properties of T-cell immunity in patients with rheumatoid arthritis during complex adaptive immunotherapy

Abstract

Introduction. Severe side effects of drugs and emerging pharmacological resistance to basic antirheumatic therapy in patients with rheumatoid arthritis (RA) warrant the search for new methods of treatment based on selective extracorporeal photochemical processing of peripheral blood mononuclear cells. This article presents the results and discusses the impact of complex adaptive immunotherapy on the subpopulation composition of lymphocytes and T-regulatory cells in patients with RA. The aim was to study the properties of T-cell immunity in patients with RA during complex adaptive immunotherapy. Methods. We examined 100 patients with a verified diagnosis of RA, according to the criteria of the American College of Rheumatology/European Antirheumatic League (ACR/EULAR, 2010). The patients were divided into a main and a control group. The main group included 50 patients that received basic anti-inflammatory drugs in combination with extracorporeal photopheresis (ECP) in a program mode (two procedures every 2.5-3 mos. for 24 mos.). The control group included 50 patients that received only standard, basic monotherapy. Results. ECP reduced the functional activity of NK cells and T-lymphocytes that expressed the α-chain of the IL-2 receptor due to an increase in T-regulatory cells in the peripheral blood in most treated patients with RA. Conclusion. The inclusion of ECP as a component of complex antirheumatic therapy in patients with RA enhances the immunomodulatory effect. This is due to an increase in the content of T-regulatory cells in the peripheral blood and a decrease in the functional activity of T-activated lymphocytes, which, in turn, restores the imbalance in the T-cell population and preserves the peripheral immunotolerance to self-antigens.