Vol.23 No.1

Original Article

Assessment of peripheral blood CD4+ adenosine triphosphate activity in patients with rheumatoid arthritis

Authors

Masaki Akimoto1 , Shingo Yunoue2 , Hideo Otsubo3 , Tamami Yoshitama3 , Kunihiro Kodama3 , Kakushi Matsushita1 , Yukio Suruga1 , Tomohiro Kozako2 , Shingo Toji4 , Sachi Hashimoto4 , Kimiharu Uozumi1,2 , Takemasa Matsuda3, Naomichi Arima1,2

  • Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan
  • Division of Hematology and Immunology, Center for Chronic Viral Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
  • Rheumatic Disease Unit, Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan
  • Medical and Biological Laboratories, Nagoya, Japan
Received:

4 November 2011

Accepted:

14 February 2012

Published online:

1 March 2012

Full Text

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Abstract

Objective The ability of the ImmuKnow (Cylex) assay to predict the risk of infection in rheumatoid arthritis (RA) patients receiving synthetic or biological disease-modifying antirheumatic drugs (DMARDs) was examined.
Methods The amount of adenosine triphosphate (ATP) produced by CD4+ cells in response to phytohemagglutinin was measured in whole blood from 117 RA patients without infection versus 17 RA patients with infection, and compared with results in 75 healthy controls.
Results The mean ATP level was significantly lower in patients with infection compared to both healthy controls (P<0.0005) and patients without infection (P = 0.040). Also, the mean ATP level in patients without infection was significantly lower than that in healthy controls (P = 0.012). There was no correlation between the ATP level and the Disease Activity Score in 28 joints.
Conclusion ImmuKnow assay results may be effective in identifying RA patients at increased risk of infection, but the results showed no correlation with RA activity. Larger studies are required to establish the clinical advantages of this assay in RA treatment.

Key words

CD4+ cell - ImmuKnow - Immune cell function - Infection - Rheumatoid arthritis