Treatments with fractionated total lymphoid irradiation (TLI) and cyclophosphamide were evaluated for rats injected with type I1 collagen. Preadministration of TLI and repeated injections of cyclophosphamide suppressed the severity of arthritis and lowered antibody titers to collagen significantly. TLI initiated at the onset of collagen arthritis decreased humoral and cellular responses to collagen but did not affect the severity of arthritis. These data demonstrate that both TLI and cyclophospharnide are immunosuppressive in an experimentally inducible autoimmune disease.The immunosuppression produced in mice by fractionated total lymphoid irradiation (TLI) can pro-A preliminary account of this work was presented at the annual meeting of the American Rheumatism Association at Boston, MA, June 5 , 1981, and was published in abstract form in Arthritis and Rheumatism, 242359, 1981. From long allogeneic skin (1,2) and bone marrow (2-5) engraftment , expedite the development of tolerance to foreign protein antigens (6), decrease the antibody response to a foreign antigen (7), and ameliorate autoimmune disease in the NZB/NZW (8,9) and MRL/1 (10) strains. In rats, TLI has been shown to facilitate the induction of allograft tolerance (1 1,12), to decrease, preferentially, lymphocyte concentrations in the blood, and to partially suppress adjuvant arthritis (13). In view of the prospect of using this technique [which is a recognized therapy for Hodgkin's disease (14,15)] as an alternative to cytotoxic drug therapy (16,17) in the treatment of patients with severe rheumatoid arthritis (18,19), we investigated whether TLI could modify in rats the clinical, radiographic, and immunologic manifestations of an inflammatory polyarthritis induced by immunization with type I1 collagen (20,21). We also compared the efficacy of TLI with that of cyclophosphamide in this model.
MATERIALS AND METHODSRats. We used female Sprague-Dawley rats (Charles River Breeding Laboratories, Wilmington, MA) that weighed 100-130 gm.Collagen and immunization. Rats were immunized during ether anesthesia by intradermal injection of the dorsal skin with approximately 0.4 mg of previously prepared (22) native pepsin-modified chick type I1 collagen dissolved in 0.1M acetic acid and emulsified in incomplete Freund's adjuvant (20). In one experiment, immunized rats were boosted with approximately 0.4 mg of dissolved collagen that was injected intraperitoneally (20).Irradiation. Rats were irradiated with a 250-kV Westinghouse x-ray machine operated at 15 mamp at a rate of 40 rads per minute and a source-axis distance of 60 cm. The beam was corrected with 0.5-mm copper and 1 .O-mm alumi- (13), except for these modifications: the anatomic confines of the thymus and spleen were identified by autopsies, and the ports over these organs were slightly enlarged to ensure total inclusion of these tissues. Because of the lateral scatter that occurs when irradiation is delivered in this energy spectrum (23,24), vertical lead shields, 2 mm in thickness, were positioned...