Document Detail

Lymphocyte transformation test is not helpful for the diagnosis of methotrexate-induced pneumonitis in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  19559690     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The pathophysiology underlying methotrexate (MTX)-induced pneumonitis has been considered as a hypersensitive reaction. The lymphocyte transformation test (LTT) is frequently used to detect hypersensitivity. Whereas previous reports have proposed that the LTT is not ideal to detect hypersensitivity to MTX, it has not been directly confirmed. METHODS: Forty rheumatoid arthritis (RA) patients (24 patients currently taking MTX and 16 patients with a past history of MTX administration) and 13 healthy subjects were recruited. LTT with MTX was used to assess thymidine incorporation. An MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt) assay was also performed. The mitogenic activity was expressed as the Stimulatory Index (SI). The activity of RA was assessed by the disease activity score 28 (DAS28). RESULTS: In the presence of MTX, the SI measured by the LTT and by the MTS assay showed an inverse correlation. The presence of MTX significantly elevated the SI values measured by the LTT. However, the SI values were significantly lower in RA patients currently taking MTX than those of patients not currently taking MTX, although DAS28 was not different. Furthermore, a past history of MTX-induced pneumonitis did not affect the SI values. CONCLUSION: LTT with MTX in RA patients is not appropriate to detect MTX-induced pneumonitis.
Shintaro Hirata; Noboru Hattori; Kazuhiko Kumagai; Yoshinori Haruta; Akihito Yokoyama; Nobuoki Kohno
Publication Detail:
Type:  Journal Article     Date:  2009-06-25
Journal Detail:
Title:  Clinica chimica acta; international journal of clinical chemistry     Volume:  407     ISSN:  1873-3492     ISO Abbreviation:  Clin. Chim. Acta     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302422     Medline TA:  Clin Chim Acta     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  25-9     Citation Subset:  IM    
The Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
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MeSH Terms
Arthritis, Rheumatoid / drug therapy*,  immunology,  metabolism
Case-Control Studies
Cell Proliferation / drug effects
Lymphocyte Activation / drug effects*
Methotrexate / adverse effects*
Pneumonia / chemically induced*,  diagnosis*,  immunology,  metabolism
Reproducibility of Results
Tetrazolium Salts / metabolism
Thiazoles / metabolism
Time Factors
Reg. No./Substance:
0/Tetrazolium Salts; 0/Thiazoles; 138169-43-4/3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium; 59-05-2/Methotrexate

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