Intracytoplasmic Cytokine Expression and T Cell Subset Distribution in the Peripheral Blood of Patients with Ankylosing Spondylitis

Objective. To determine the role of inflammatory mediators in the pathogenesis of ankylosing spondylitis (AS), we investigated peripheral blood lymphocyte subsets and their intracellular cytokine production. Methods. The percentages of T and B lymphocytes, natural killer (NK) cells, activated T lymphocytes, CD4+ T helper (Th), and CD8+ T cytotoxic (Tc) cells were determined by flow cytometry in 42 patients with AS compared to 52 healthy controls. In order to assess circulating Th1/Th2 and Tc1/Tc2 Subsets, we used a whole-blood cytometric assay based on the intracellular interferon-gamma, interleukin 4 (IL-4), and IL-10 expression of the cells. Results. In the peripheral blood, the frequencies of CD4+ T helper and CD56+ NK cells were higher in AS (54.8% and 16.2%, respectively) compared to controls (45.3% and 10.8%) (p < 0.05)., The frequencies of Th0 (1.9% vs 0.8%) and Tc0 (2.1 % vs 0.8%) cells were higher, while that of Tc1 cells was lower (26.6% vs 40.1%) in patients with AS versus controls (p < 0.05). The percentage of IL-10-producing Tc cells was significantly higher in AS (18.4%) versus controls (8.5%) (p < 0.05). Finally, the active phase of AS was associated with significantly lower percentage of IL-10-producing Tc cells in the peripheral blood (6.6%) compared to patients with inactive AS (23.1%). Conclusion. Our results provide further evidence for an altered T cell subset distribution and intracytoplasmic cytokine balance in AS. (First Release Nov 1 2008: 1 Rheumatol 200835:2372-5: doi: 10.3899/jrheum.070839)