Comparison of synovial tissues from the knee joints and the small joints of rheumatoid arthritis patients - Implications for pathogenesis and evaluation of treatment
Comparison of synovial tissues from the knee joints and the small joints of rheumatoid arthritis patients - Implications for pathogenesis and evaluation of treatment
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DOI：
10.1002/art.10556
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发表时间：
2002-08-01
影响因子：
--
通讯作者：
Tak, PP
中科院分区：
文献类型：
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作者：
Kraan, MC;Reece, RJ;Tak, PP
Objective.系列滑膜活检样本越来越多地用于评估类风湿性关节炎（RA）的新疗法。大多数研究使用的是膝关节活检组织，但技术的进步也使连续的小关节镜检查变得可行。从理论上讲，由于机械因素、神经支配的差异和其他因素，不同关节之间的滑膜炎症特征可能存在差异。因此，我们进行了这项研究，以比较细胞浸润配对滑膜活检样品从发炎的膝关节和配对发炎的小关节的RA患者。9例膝关节和小关节（腕关节或掌指关节）同时发炎的RA患者在同一天接受了关节镜下两个关节的滑膜活检。收集多个活检标本，并通过免疫组织化学对巨噬细胞、T细胞、浆细胞、成纤维细胞样滑膜细胞和白细胞介素-6（IL-6）进行染色。通过数字图像分析对切片进行评价。与来自小关节的样品相比，在来自膝关节的样品中研究的所有标志物的平均细胞数没有显著差异。我们检测到膝关节和小关节之间的亚衬巨噬细胞、T细胞和浆细胞的数量以及IL-6表达的统计学显著相关性。但不同关节间内膜巨噬细胞和成纤维细胞样滑膜细胞的数量无明显相关性。这项研究的结果表明，一个发炎关节的炎症通常代表其他发炎关节的炎症。因此，可以使用来自同一关节的系列样本，选择大关节或小关节，用于评价抗风湿治疗。
Objective. Serial synovial biopsy samples are increasingly being used for the evaluation of novel therapies for rheumatoid arthritis (RA). Most studies have used tissues from knee biopsies, but technical improvements have made serial small joint arthroscopy feasible as well. Theoretically, there could be differences in the features of synovial inflammation between various joints as a result of mechanical factors, differences in innervation, and other factors. We therefore undertook this study to compare the cell infiltrate in paired synovial biopsy samples from inflamed knee joints and paired inflamed small joints of patients with RA.Methods. Nine RA patients with both an inflamed knee joint and an inflamed small joint (wrist or metacarpophalangeal joint) underwent an arthroscopic synovial biopsy of both joints on the same day. Multiple biopsy specimens were collected and stained for macrophages, T cells, plasma cells, fibroblast-like synoviocytes, and interleukin-6 (IL-6) by immunohistochemistry. Sections were evaluated by digital image analysis.Results. There were no significant differences in mean cell numbers for all markers investigated in samples from the knee joint compared with samples from the small joints. We detected statistically significant correlations for the numbers of sublining macrophages, T cells, and plasma cells, as well as for IL-6 expression, between the knee joint and the small joints. However, there was no significant correlation between different joints for the numbers of intimal macrophages or fibroblast-like synoviocytes.Conclusion. The results of this study show that the inflammation in one inflamed joint is generally representative of that in other inflamed joints. Therefore, it is possible to use serial samples from the same joint, selecting either large or small joints, for the evaluation of antirheumatic therapies.