Extracorporeal Irradiation of Thoracic Duct Lymph as Immunosuppressive Treatment in Rheumatoid Arthritis

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Abstract
Thoracic duct drainage and re-infusion of the irradiated lymph was carried out as immunosuppressive treatment in 2 patients with progressive, therapy-resistant rheumatoid arthritis. In both patients, a marked clinical improvement was achieved even during the first days of treatment. A reduced number of T cells in the Mood was seen 3 days after onset of drainage, whereas no significant change in the number of B cells was observed. No recirculation of the infused cells could be detected, nor was the radiation removal of T cells accompanied by rapid proliferation of “new” T cells. As clinical improvement and reduction in T cells occurred simultaneously, there is probably a connection between these two events. The beneficial clinical response and the achievement of T cell suppression by thoracic duct drainage–the result of irradiation and re-infusion of irradiated lymph–encourage further clinical trials with this type of treatment in severe therapy-resistant rheumatoid arthritis.