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Cell-mediated immunity has been implicated in the pathogenesis of polymyositis (PM). We conducted a prospective study in which serum levels of soluble interleukin-2 receptors (IL-2R), IL-1 alpha, and IL-2 were correlated with creatine kinase (CK) levels and clinical disease activity. Cytokines and IL-2R were quantitated in 133 serum samples from 14 patients by use of an enzyme-linked immunosorbent assay. In patients with acute PM (9 patients), soluble IL-2R and IL-1 alpha levels were elevated initially, but declined rapidly with therapy. A significant linear relationship was found between soluble IL-2R levels and CK levels. IL-2 was initially detectable in only 3 patients, and it disappeared with therapy in all 3. The levels of cytokines and IL-2R were consistently normal in patients with inactive PM (2 patients). In patients with chronic PM (3 patients), the cytokines and soluble IL-2R levels were normal despite persistently abnormal CK levels and/or muscle weakness. Cellular IL-2R levels correlated positively with serum levels of soluble IL-2R. Our studies substantiate a pathogenic role for cellular immunity in PM, with the finding of activation of lymphocytes. The finding of increased levels of IL-1 alpha demonstrates for the first time that there is monocyte activation in PM. Persistent elevation of CK levels after normalization of the levels of cytokines and IL-2R may be prognostic of impending chronic disease. Serum soluble IL-2R appear to be a sensitive indicator of improvement or exacerbation of disease activity in patients with PM.

Multiple injections of spleen cells from young NZB x NZW F1 hybrid mice with a mean age of 9 weeks were administered to syngeneic recipients at 10-day intervals beginning at 3 months of age. The recipient mice had a dealyed appearance of antinuclear antibody, decreased cumulative incidence of antinuclear antibody positivity up to 7.3 months of age, lower cumulative mortality up to 8 months of age, and a lesser degree of glomerular sclerosis at 8 months of age. By 9 months of age no significant differences in these parameters remained. Transferred cells were most effective during the 4- to 6-week period immediately following initiation of injections. The beneficial effects appeared to reflect an early but temporary suppression of the autoimmune process by the transferred lymphoid cells.

The cell-mediated immune response of lymphocytes to rubella, measles, parainfluenza types 1, 2, and 3, varicella-zoster, and herpes virus type 1 virus antigens was evaluated in 15 SLE patients and 15 matched controls by incorporating 3H-thymidine in whole blood cultures as a measure of blastic transformation. SLE patients were less responsive than normal individuals to six of eight virus antigens tested. Culture of washed SLE cells in AB plasma did not reverse the hyporesponsiveness. The results indicated that a functional impairment of the circulating lymphocytes appeared to be responsible for the in vitro hyporesponsiveness of SLE patients to virus antigens.