The role of the MA-sensitive leukocyte chemotaxis in rheumatoid arthritis. A randomized double-blind clinical trial of griseofulvin treatment

Abstract

Polymorphonuclear leukocyte (PMN) chemotaxis is thought to play an essential role in the pathogenesis of rheumatoid arthritis. PMN chemotaxis is in part sensitive to microtubule antagonists (MAs), e.g. colchicine. The antimycotic antibiotic griseofulvin inhibits the MA-sensitive PMN chemotaxis in vitro in concentrations far below those obtained in serum during antimycotic therapy. The role of the MA-sensitive chemotaxis in rheumatoid arthritis could thus be elucidated by a clinical trial of griseofulvin treatment. Griseofulvin (n = 20) was tested in a randomized double-blind study versus placebo (m = 19) during one year in patients with rheumatoid arthritis of mild-moderate activity. No beneficial effect of griseofulvin treatment was noted on clinical symptoms or laboratory parameters of rheumatoid arthritis. Moreover, the placebo-treated patients showed more improvement than the griseofulvin-treated patients. It is therefore suggested that the MA-sensitive chemotaxis plays a reparative role in the inflammatory lesions of rheumatoid arthritis.