Peripheral blood mononuclear cells from patients with rheumatoid arthritis suppress erythropoiesis in vitro via the production of tumor necrosis factor alpha

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Abstract
Anemia is a frequent manifestation of rheumatoid arthritis, with a probably multifactorial etiology. We investigated the effect of peripheral blood mononuclear cell supernatants (PBMCS) from rheumatoid arthritis (RA) patients on hematopoietic colony formation in vitro, by using a methylcellulose assay. PBMCS from patients suppress in vitro erythroid (BFU‐E), mixed‐lineage (CFU‐GEMM) and to a lesser degree granulocyte‐macrophage (CFU‐GM) progenitors. PBMCS from anemic RA patients were more suppressive for BFU‐E than those from non‐anemic patients. Addition of antibodies to tumor‐necrosis factor alpha (TNFα) almost completely reversed the inhibition of BFU‐E and CFU‐GEMM, but had little effect on the CFU‐GM colony formation. Antibodies to interferon‐gamma (IFNγ) and interleukin‐1 (IL‐1) were not effective. The above data suggest that PBMCS from RA patients suppress in vitro erythropoiesis via the production of TNFα; a pathogenetic role for TNFα in the anemia of RA can be implied.