These studies explore the role of lymphocytes in the pathogenesis of inflammatory arthritis and attempt to identify therapeutic alternatives for treatment-resistant autoimmune rheumatic diseases. The clinical efficacy, toxicity, and immunological effects of the newer adenosine analogs, such as fludarabine are being studied in patients with autoimmune rheumatic disorders in phase I/II clinical studies. These agents primarily affect lymphoid cells because these cells contain an enzyme necessary for activation of these compounds. Previous investigations employing these drugs in patients with low-grade lymphoid malignancies have shown that they selectively target immune cells by inducing a physiologic form of cell death called apoptosis. Their effects on the clinical course of immunologic diseases, as well as on the function of immune cells have not been characterized.
