CD25(bright)CD4(+ )regulatory T cells are enriched in inflamed joints of patients with chronic rheumatic disease

CD25(+)CD4(+ )regulatory T cells participate in the regulation of immune responses. We recently demonstrated the presence of CD25(bright)CD4(+ )regulatory T cells with a capacity to control T cell proliferation in the joints of patients with rheumatoid arthritis. Here, we investigate a possible accumulation of these regulatory T cells in the inflamed joint of different rheumatic diseases including rheumatoid arthritis. The studies are also extended to analyze whether cytokine production can be suppressed by the regulatory T cells. Synovial fluid and peripheral blood samples were obtained during relapse from 36 patients with spondyloarthropathies, 21 adults with juvenile idiopathic arthritis and 135 patients with rheumatoid arthritis, and the frequency of CD25(bright)CD4(+ )T cells was determined. Of 192 patients, 182 demonstrated a higher frequency of CD25(bright)CD4(+ )T cells in synovial fluid than in peripheral blood. In comparison with healthy subjects, the patients had significantly fewer CD25(bright)CD4(+ )T cells in peripheral blood. For functional studies, synovial fluid cells from eight patients were sorted by flow cytometry, and the suppressive capacity of the CD25(bright)CD4(+ )T cells was determined in in vitro cocultures. The CD25(bright)CD4(+ )T cells suppressed the production of both type 1 and 2 cytokines including interleukin-17, as well as proliferation, independently of diagnosis. Thus, irrespective of the inflammatory joint disease investigated, CD25(bright)CD4(+ )T cells were reduced in peripheral blood and enriched in the joint, suggesting an active recruitment of regulatory T cells to the affected joint. Their capacity to suppress both proliferation and cytokine secretion might contribute to a dampening of local inflammatory processes.