Decreased tissue immunoregulatory index in rheumatoid synovitis, determined by in-situ T-cell phenotyping with monoclonal antibodies
The phenotypic tissue immunoregulatory index in rheumatoid synovitis is locally different and varies significantly between given areas. Ectopic lymphoid follicles show normal to high T4∶T8 ratios, whereas within the sublining perivascular and diffuse infiltrate T4∶T8 ratios are decreased. Thus the frequency reported immunoregulatory indices of eluted cells can't be representative for an immunoregulatory tissue disequilibrium in rheumatoid arthritis. An elevated T4∶T8 ratio in eluted cells may correlate with a follicular B-cell hyperplasia in rheumatoid synovitis (low local activity), a low T4∶T8 ratio may be related to rheumatoid synovitis with diffuse sublining T-cell infiltrates (high local activity). Our results are in principal accordance with the findings of Kurosaka and Ziff  and Meijer et al. . They also found different T-cell distributions in synovial tissue depending on the histopathological localization.
For these topographical reasons, immunoregulatory indices determined in eluted cells from tissue samples cannot be representative for the immunopathological reactions at the synovial membrane tissue level.
The decrease in the phenotypic tissue immunoregulatory index in the rheumatoid synovium from deeper to superficial areas may be explained as a compensatory influx of peripheral, functionally defect T8-cytotoxic/suppressor cells (see Fig. 2).
KeywordsLocal Activity Synovial Membrane Tissue Meijer Lymphoid Follicle Rheumatoid Synovium
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