Circulating CD8 T Cells in Polymyalgia Rheumatica and
Giant Cell Arteritis: A Review
Victor M. Martinez-Taboada, Ricardo Blanco, Concepcio ´nFito,
Maria Jose Bartolome Pacheco, Miguel Delgado-Rodriguez, and
Vicente Rodriguez-Valverde
Background and Objective: During the last few years, there have been
several studies on T cell subsets in polymyalgia rheumatica (PMR) and giant
cellarteritis(GCA),withconflictingresults.Whereassomeauthorshavefound
normal values of circulating CD8 T cells, others have found a decreased
number.Furthermore,insomestudies,thelevelofCD8 cellswasfoundtobe
related to disease activity, and it has been proposed that a decrease of CD8
TcellsbeusedasadiagnosticcriterionforPMR.Thepurposeofourstudywas
to determine the value of assessing T cell subsets in PMR and GCA.
Methods: Tlymphocytesubsetsweredeterminedbyflowcytometryusinga
whole blood lysis technique in the following groups: 28 PMR and 6 GCA
patients before corticosteroid treatment, 20 PMR and 12 GCA patients in
clinical remission with steroid treatment, 55 PMR patients in remission with-
out steroid treatment, 17 rheumatoid arthritis (RA) patients before treatment,
and 18 age-matched controls with noninflammatory conditions. Total white
cell, lymphocyte, and platelet counts, hemoglobin, C-reactive protein (CRP),
and erythrocyte sedimentation rate (ESR) were measured by routine tech-
niques. Comparisons were made by the Student’s t-test and the Mann-Whit-
ney test. A MEDLINE database search for studies published between 1983 and
1997 was performed.
Results: Compared with noninflammatory controls, CD8 T cells were not
reduced before steroid treatment in patients with active PMR/GCA in propor-
tion (P .7) or absolute numbers (P .1). Patients with active disease had
significantlylowerhemoglobinlevelsandhigherplateletcounts,CRP,andESR
than noninflammatory controls (P < .05). When compared with active RA,
CD8 T cells were not reduced in patients with active PMR in proportion (P
.5)orabsolutenumbers(P .2).Betweenthesetwogroups,RApatientswere
significantly younger (P .003) and had lower ESR values (P .003). We did
not find significant differences between patients with active PMR/GCA and
those in remission with steroid therapy, except for the lower hemoglobin
levelsandhigherplateletcount,CRP,andESRintheactivediseasegroup(P <
.05). The same results were found when patients with active disease were
From the Rheumatology Division, Hospital Universitario
“Marque ´s de Valdecilla,” Facultad de Medicina, Universidad de
Cantabria, Santander, Spain, and the Division de Medicina Preven-
tiva y Salud Publica, Universidad de Jae ´n.
Victor M. Martı ´nez-Taboada, MD: Staff Physician, Rheumatol-
ogy Division; Ricardo Blanco, MD: Staff Physician, Rheumatology
Division; Concepcio ´n Fito, MD: Former fellow; Vicente Rodrı ´guez-
Valverde, MD: Professor of Medicine and Chair, Rheumatology
Division; Maria J. Bartolome Pacheco, MD: Fellow in Immunol-
ogy, Hospital Universitario “Marque ´s de Valdecilla,” Facultad de
Medicina, Universidad de Cantabria, Santander, Spain; Miguel
Delgado-Rodriguez, MD: Professor of Medicine, Divisio ´n de Me-
dicina Preventiva y Salud Pu ´blica, Universidad de Jae ´n.
Supported by a grant from “Fundacio ´n Marque ´s de Valde-
cilla” 1996 and 1998, a grant of “Caja Cantabria” 1996,
and Fondo de Investigacio ´ n Sanitaria (98/0846). C. Fito was
supported by a grant of “Fundacio ´n Marque ´s de Valde-
cilla.”
Address reprint requests to Victor M. Martı ´nez-Taboada,
MD, Rheumatology Division, Hospital Universitario “Marque ´s
de Valdecilla,” Avenida de Valdecilla s/n, 39008 Santander,
Spain; E-mail: vmartinezt@medynet.com
Copyright © 2001 by W.B. Saunders Company
0049-0172/01/3004-0921$35.00/0
doi:10.1053/sarh.2001.9734
257 Seminars in Arthritis and Rheumatism, Vol 30, No 4 (February), 2001: pp 257-271