The reaction against autologous lymphoblasts as an indicator of lymphocyte hyperreactivity in rheumatoid arthritis.

We have previously found that there is a considerable variation in the responses of lymphocytes of normal individuals to autologous pokeweed mitogen (PWM)-induced lymphoblasts (PWM.AMLR) under completely autologous conditions. Having proposed that the reaction might measure an innate sensitivity for B cell hyperreactivity, we measured the PWM.AMLR of a normal group (8/18 positives) and a group of patients with rheumatoid arthritis (RA; 24/25 positives). Responses of the RA group were in general an order of magnitude greater than those of normal controls that generated positive responses, and the responding cells could clearly be shown to be both CD4-bearing and CD8-bearing T cells. T cell-independent B cell mitogen-induced (staphylococcus A) lymphoblasts derived from RA patients were capable of strongly stimulating autologous responder cells, while similarly treated cells of normal controls induced small responses. The staphylococcus A responses were smaller in general than those induced by PWM-induced lymphoblasts. These results support previous results that the degree of activation of both T cells and B cells determines the size of response in the autologous PWM.AMLR and that the PWM.AMLR may be used to determine differing degrees of the in vivo priming of these cells and their relation to clinical lymphocyte hyperreactivity.