Systemic and local expression of perforin in lymphocyte subsets in acute and chronic rheumatoid arthritis

Gordan Gulan, Jagoda Ravlic-Gulan, Natasa Strbo, Vlatka Sotosek, Boris Nemec, Damir Matovinovic, Dusan Rubinic, Eckhard R. Podack, Daniel Rukavina

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective. To investigate the role of the cytolytic action mediated by perforin in the course of rheumatoid arthritis (RA), we studied the immunophenotypic characteristics of lymphocytes containing perforin in peripheral blood (systemic level), in synovial fluid (SF), and in the synovial membrane (local level) in patients during the acute or chronic phase of RA. Cells from patients with osteoarthritis were used as controls. Methods. Flow cytometry was used for simultaneous detection of intracellular (perforin) and cell surface antigens. Mean fluorescence intensity (MFI) was a measure of the mean perforin content per cell. Immunocytochemical staining was used to visualize perforin in the cytoplasmic compartment of cells. Results. In acute RA highly significant changes in perforin expression were found in all compartments (peripheral blood, SF, and synovial membrane): (1) increase of percentage of total perforin positive cells; (2) increase of both subsets of cytolytic cells, T (CD8+P+) and NK (CD56+P+) cells; (3) increase in the frequency of perforin positive cells in CD8+ and CD56+ cell populations; and (4) the highest content of perforin/cell (MFI values) in all compartments, except in the synovial membrane. Conclusion. Perforin positive cells may participate in the acute phase of RA by maintaining and perpetuating inflammation and contributing to tissue destruction.

Original languageEnglish (US)
Pages (from-to)660-670
Number of pages11
JournalJournal of Rheumatology
Issue number4
StatePublished - Apr 1 2003
Externally publishedYes


  • Blood
  • Lymphocyte mediated cytotoxicity
  • Perforin
  • Rheumatoid arthritis
  • Synovial tissue

ASJC Scopus subject areas

  • Rheumatology
  • Immunology


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