The present study was designed to compare peripheral blood neutrophil migration and leukotriene (LT) release between patients with rheumatoid arthritis (RA) and healthy controls and to correlate the neutrophil functions with clinical disease activity. Nineteen patients with moderately active RA and 19 age and sex matched healthy volunteers participated in this study. Isolated peripheral blood neutrophils from RA patients released equal amounts of LTB4 but their random migration was enhanced as compared with neutrophils from healthy controls. LTB4 release in whole blood was significantly lower in samples from RA patients than in those from the healthy volunteers (13.5 +/- 1.4 and 19.1 +/- 1.4 ng/10(6) neutrophils respectively; P < 0.001). LTB4 release from isolated RA neutrophils correlated with the levels of C-reactive protein, duration of morning stiffness and Ritchie articular swelling index. Concentrations of hyaluronate, cyclic AMP and 13, 14-dihydro-15-keto prostaglandin were not different between patients with RA and healthy volunteers. Neither was there any difference in TXB2 production by platelets during blood clotting. In conclusion, peripheral blood neutrophils of RA patients seem to be primed and/or activated as their random migration is enhanced as compared with those of healthy volunteers. In RA, LTB4 release from peripheral blood neutrophils seems to reflect the clinical activity of the disease. However, RA neutrophils released smaller (in whole blood) or equal (isolated cells) amount of LTB4 as compared with the respective controls. These contradictory findings suggest that LTB4 release from peripheral blood neutrophils has no major role in the regulation of disease activity in rheumatoid arthritis.