Juvenile arthritis and autoimmunity to type II collagen.

Published

Journal Article

OBJECTIVE: Joint inflammation in juvenile rheumatoid arthritis (JRA) is sometimes associated with an autoimmune response to type II collagen (CII), a cartilage-specific protein. To test the hypothesis that down-regulation of autoimmunity to CII can be accomplished in JRA by oral administration of CII, an open-label study of CII was performed in 9 patients with JRA. METHODS: Seven rheumatoid factor-negative JRA patients with polyarticular disease and 2 JRA patients with pauciarticular disease (1 with early onset and 1 with late onset) were treated for 3 months with oral bovine CII. Patients were examined for disease activity and underwent routine laboratory testing at monthly intervals. Two of the patients had flares of disease when treatment was discontinued, and these patients were re-treated for an additional 3 months. To test the hypothesis that oral tolerance induces an immune deviation of T cells, peripheral blood mononuclear cells from patients were collected before and after treatment and cultured with CII. Supernatants and RNA were collected and analyzed for the presence of various cytokines. RESULTS: Eight patient trials met the criteria for clinical improvement outlined by Giannini and coworkers in 1997. None of the patients had any side effects from the treatment. In 6 of the 8 patients who improved, interferon-gamma production decreased after oral CII therapy, correlating with clinical improvement, while 6 patients had increases in levels of transforming growth factor beta3. CONCLUSION: These results are encouraging. The possible beneficial effect of oral CII in JRA merits further investigation.

Full Text

Duke Authors

Cited Authors

  • Myers, LK; Higgins, GC; Finkel, TH; Reed, AM; Thompson, JW; Walton, RC; Hendrickson, J; Kerr, NC; Pandya-Lipman, RK; Shlopov, BV; Stastny, P; Postlethwaite, AE; Kang, AH

Published Date

  • August 2001

Published In

Volume / Issue

  • 44 / 8

Start / End Page

  • 1775 - 1781

PubMed ID

  • 11508428

Pubmed Central ID

  • 11508428

International Standard Serial Number (ISSN)

  • 0004-3591

Digital Object Identifier (DOI)

  • 10.1002/1529-0131(200108)44:8<1775::AID-ART313>3.0.CO;2-V

Language

  • eng

Conference Location

  • United States