Alefacept treatment in XXXX : reduction of the effector T cell population in peripheral blood and synovial tissue is associated with improvement of clinical signs of arthritis.

@entity1 @entity32 @entity404 @entity3138 @entity5144 @entity7937 @entity405
OBJECTIVE: To investigate whether alefacept (a fully @entity1 lymphocyte function-associated antigen 3 [ @entity7937 ]/IgG1 fusion protein that blocks the @entity7937 / @entity3138 interaction) is able to reduce the signs and symptoms of @entity32 in @entity1 with active @entity5144 ( @entity5144 ). METHODS: Eleven @entity1 with active @entity5144 were treated with alefacept for 12 weeks in an open-label and explorative study. Clinical joint assessment and laboratory assessments were performed at baseline and after 4, 9, 12, and 16 weeks of treatment. Serial synovial tissue (ST) biopsy specimens from an inflamed index joint (knee, ankle, wrist, or metacarpophalangeal joint) were obtained by arthroscopy at baseline and after 4 and 12 weeks of treatment. RESULTS: At the completion of treatment, 6 of 11 @entity1 (55%) fulfilled the Disease Activity Score (DAS) response criteria. Nine @entity1 (82%) fulfilled the DAS response criteria at any point during the study. There was a statistically significant reduction in @entity404 + lymphocytes (P < 0.05), @entity405 + lymphocytes (P = 0.05), and CD68+ macrophages (P < 0.02) in the ST after 12 weeks of treatment compared with baseline. The ST and peripheral blood of those @entity1 fulfilling the DAS response criteria contained more CD45RO+ cells at baseline and displayed a significant reduction in these cells compared with nonresponding @entity1 . CONCLUSION: The changes in ST, together with the improvement in clinical joint scores, after treatment with alefacept support the hypothesis that T cell activation plays an important role in this chronic inflammatory disease. Furthermore, since alefacept, a T cell-specific agent, led to decreased macrophage infiltration, the data indicate that T cells are highly involved in @entity32 in @entity5144 .
