Myeloid cell cascade bearing onco-fetal membrane structure found in the involved epiphyseal bone marrow in patients with severe active rheumatoid arthritis

主要目的是研究骨髓在类风湿性关节炎等多发性关节炎的诱发或持续中的作用。在实验性多发性关节炎中，病理变化主要见于骨髓。在滑膜细胞增殖开始之前，骨髓中可观察到骨髓细胞的发育和增殖，以及IL-1和IL-6的升高。在RA的持续性严重炎症过程中，某些未分化细胞的不可控制的增殖可伴随着正常细胞的破坏和解体。我们发现在严重活动性类风湿关节炎患者的骨髓中存在异常的髓系细胞的积累，这些细胞具有异常的碳水化合物膜结构。发现在这些病变中聚集的多形性白细胞，即髓系成熟细胞，含有异常高水平的IL-1。 关于我们 艾德骨髓作为全身造血器官。在髂骨髓中，每个单核细胞组分的数量都非常显著地增加。活化的（HLA DR+）CD 8细胞明显增加。在自然病程的RA患者中，重度和轻度患者的骨髓中均存在着明显的细胞凋亡。严重破坏性病变的类风湿关节炎患者髂骨髓中髓样细胞明显增多。结果发现，严重破坏性RA患者骨髓中的异常髓系细胞在骨骺骨髓中大量聚集，骨髓中的细胞因子也明显增多。RA患者骨髓中IL-6、IL-8水平升高，外周血中IL-6、IL-8水平也升高，但明显低于骨髓。IL-6、IL-8的升高与多关节滑膜炎的加重密切相关，因此，在RA患者中，髂骨髓可能是主要的病变，并可影响外周血和骨骺骨髓。我们正在进一步调查骨髓在诱导RA中的作用。少

Main purpose is to study the role of bone marrow in inducing or persisting poly-arthritis like rheumatoid arthritis. In experimental polyarthritis, pathological changes were seen primarily in bone marrow. Preceding the beginning of synovial proliferation, the cellular development and proliferation of bone marrow cells and the elevation of IL-1 and -6 could be observed in bone marrow. Thus, the role of bone marrow in inducing polyarthritis were impressed.In the persistent severe inflammatory process of RA, some uncontrollable proliferation of a certain type of undifferentiated cells could be accompanied by destruction and disorganization of normal cells. We found an accumulation of abnormal myeloid lineage bearing aberrant carbohydrate membrane structures in the bone marrow of patients with severe active rheumatoid arthritis. Polymorphonuclear leukocytes, mature cells of myeloid lineage, accumulating in these lesions were found to contain unususally high levels of IL-1.We further survey … More ed bone marrow of ilium as a systemic hemopoietic organ. In iliac bone marrow, numbers of each mononuclear cell fractions were highly significantly increased. The increase of activated (HLADR+) CD8 cells were significant. in iliac bone marrow of RA patients with both severe and mild natural course. The increase of myeloid cells in iliac bone marrow was significant in patients with severe destructive disease of RA. The abnormal myeloid cells primarily found in the epiphyseal bone marrow were found to accumulate much more in the iliac bone marrow of patients with severe destructive RA.Cytokines were also surveyed in bone marrows. In the iliac bone marrow of RA patients, elevation of IL-6, and IL-8 were characteristically found. The elevation of these cytokines in peripheral blood were also found, but the levels were much less than those in the iliac bone marrow. Interestingly, the elevation of IL-6, -8 showed close relationships with exacerbation of synovitis in multiple joints.Thus, in RA patients, iliac bone marrow could be a primarily important lesion, and could influence the peripheral blood and epiphyseal bone marrow. We are further surveying the roles of bone marrow in inducing RA. Less