Comparative histopathological analysis between tenosynovitis and joint synovitis in rheumatoid arthritis
Comparative histopathological analysis between tenosynovitis and joint synovitis in rheumatoid arthritis
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DOI：
10.1111/j.1365-2559.2008.03050.x
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发表时间：
2008-06-01
期刊：
影响因子：
6.4
通讯作者：
Iwamoto, Y.
中科院分区：
文献类型：
--
作者：
Kaibara, N.;Yamada, H.;Iwamoto, Y.
目的：探讨类风湿性关节炎（RA）伴发腱鞘炎的组织学和生物学特征。方法和结果：对6例RA患者的腕关节和指伸肌腱进行滑膜组织切片，采用苏木精、伊红染色和免疫组化分析。RA关节滑膜炎表现为典型的RA关节滑膜炎组织学特征，包括滑膜内膜增生和白细胞浸润，以CD4+ T细胞和CD68+巨噬细胞为主。值得注意的是，在每个个体的腱鞘和关节滑膜之间，CD4+ T细胞和CD68+巨噬细胞的数量有显著的相关性。实时逆转录聚合酶链反应分析显示，各种炎症介质在腱鞘炎和关节滑膜炎中的mRNA表达模式相似。我们还观察到，从腱鞘分离出来的滑膜成纤维细胞在增殖和产生炎症介质方面与从关节滑膜分离出来的成纤维细胞表现相似。结论：类风湿关节炎腱鞘炎的组织病理学特征与关节滑膜炎难以区分。因此，我们认为持续的炎症在腱鞘和关节滑膜中是由类似的机制驱动的，RA可能是一种针对全身滑膜组织的组织特异性疾病。
Aims: To clarify the histological and biological features of tenosynovitis accompanying rheumatoid arthritis (RA).Methods and results: Synovial tissue was obtained from the wrist joint and extensor tendon of the digits of six RA patients and the sections were examined by haematoxylin and eosin staining and immunohistochemical analysis. RA tenosynovitis exhibited the typical histological features of RA joint synovitis, including hyperplasia of the synovial lining and infiltration of leucocytes, largely CD4+ T cells and CD68+ macrophages. Notably, there was a significant correlation in the number of CD4+ T cells and CD68+ macrophages between the tenosynovium and joint synovium in each individual. Real-time reverse transcriptase-polymerase chain reaction analysis revealed similar mRNA expression patterns of various inflammatory mediators in tenosynovitis and joint synovitis. It was also observed that synovial fibroblasts isolated from the tenosynovium behaved in a manner similar to those isolated from the joint synovium with regard to proliferation and the production of inflammatory mediators.Conclusions: The histopathological features of RA tenosynovitis were indistinguishable from those of joint synovitis. Therefore, it is suggested that the ongoing inflammation is driven by similar mechanisms in the tenosynovium and joint synovium and that RA is probably a tissue-specific disease which targets systemic synovial tissues.