Joint capsule collagen--an analysis by study of pressure-volume curves. Measurements in control, rheumatoid and Ehlers-Danlos knees.
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The authors make a histological and histochemical study of the articular capsule, in arthrosis and senescence. They basically observe fibrosis and a decrease of the elastic tissue in aged subjects and an increase in the level of acid mucopolysaccharides of the interstitial in more than 50% of arthrosics. There are also micro-deposits of amyloid substances in more than 25% of subjects over eighty. This study provides an argument in favor of the opinion of Lagier according to which arthrosis should not be considered the same as a manifestation of senescence. On the other hand, it appears that microscopic amyloidose of the articular capsule of the old patient is not related to arthrosic phenomena but rather constitutes a local manifestation of senescence.
Twenty 6-week-old specific-pathogen-free beagles were infected with Borrelia burgdorferi by tick challenge, and five uninfected dogs served as controls. During the study, all dogs were monitored for infection, clinical signs, and antibody response against B. burgdorferi. During episodes of lameness or postmortem, synovial fluids from each dog were examined for volume, cell number, polymorphonuclear leukocyte (PMN) content, cell viability, and chemotactic activity. Twenty-five tissues collected postmortem from each dog were tested for interleukin-8 (IL-8) mRNA, tumor necrosis factor alpha (TNF-alpha) mRNA, presence of live spirochetes, and histopathological changes. Thirteen infected dogs (group A), which seroconverted rapidly (maximum titers within 50 to 90 days), developed acute and severe mono- or oligoarthritis almost exclusively in the limb closest to the tick bite (median incubation period, 66 days). Synovial fluids of the arthritic joints collected during episodes of lameness had significantly elevated volume, cell count, PMN proportion, cell viability, and chemotactic activity for PMNs. The remaining joints of the same animals contained synovial fluids with elevated chemotactic activity and cell viability. Twelve dogs tested positive for IL-8 mRNA in multiple tissues (synovia, pericardium, and peritoneum), and 10 dogs expressed TNF-alpha mRNA, but only in the tributary lymph nodes of the inflamed joints. Histological examinations revealed severe poly- or oligoarthritis and moderate to severe cortical hyperplasia in draining lymph nodes of the inflamed joints in all 13 dogs. Seven infected dogs with mild or no clinical signs (group B) seroconverted slowly (peak titers after 90 days), and only some joint fluids showed chemotactic activity, which on average was lower than that in inflamed and noninflamed joints from dogs in group A. Four dogs expressed IL-8 mRNA (in the synovia and pericardium), and three dogs had TNF-alpha mRNA in tributary lymph nodes. Histologically, nonsuppurative arthritis was found in multiple joints, and mild to moderate cortical hyperplasia was found in draining lymph nodes. Five uninfected dogs without lameness (group C) had normal synovial fluids and tissues. In all infected dogs, live spirochetes were demonstrated more frequently in tissues of the somatic quadrant closest to the tick bite than in tissues further from the site of infection, suggesting that dissemination of B. burgdorferi occurs more by migration than by blood-borne spread. From these studies employing a canine model of B. burgdorferi infection, we conclude that IL-8 is involved in the pathogenesis of acute Lyme arthritis.
1. Experiments were performed to determine whether the response of stretch-sensitive mechanoreceptors to tissue deformation is caused by the axial stretching of the tissue or by the associated transverse compression of the tissue caused by the Poisson effect. 2. Single, stretch-sensitive mechanoreceptors were recorded in vitro in a preparation of innervated, isolated capsule from the cat knee. Afferents were isolated in a ligamentous capsule thickening that has a uniform geometry and parallel collagen fibers. The tissue was loaded axially while simultaneously stretching it around the surface of a cylinder to produce compression stresses and strains. Axial stresses and strains were measured or estimated. 3. By altering the diameter of the cylinder, given axial stresses and strains produced different levels of compression stresses and strains. It was possible to compare the neuronal response to pure uniaxial tension with the response when both axial stretching and transverse compression was applied. 4. In 8 of 11 experiments, transverse compression did not significantly change the response (P > 0.05). In one experiment, the response was decreased by compression. In the other two experiments, the response was increased but was not a function of the magnitude of the compressive stress. 5. Compressive strain was not significantly correlated with neuron response in any experiment. 6. The data do not sustain the model that the responses of stretch-sensitive neurons are due to local compression of the afferent ending.
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The innervation of lumbar facet capsule and ligamentum flavum was investigated using antisera to a general neuronal marker protein gene product (PGP) 9.5 and to peptide markers of sensory nerves (calcitonin gene-related peptide [CGRP] and substance P) and autonomic nerves (vasoactive intestinal polypeptide [VIP] and C-flanking peptide of neuropeptide Y [CPON]). In the facet capsule (n = 14), PGP 9.5 and CGRP-immunoreactive nerves occurred in 12 and five specimens, respectively, both around blood vessels and as free fibers in the stroma. Free fibers immunoreactive for substance P or VIP were noted in three and five specimens, whereas in nine specimens there were CPON-immunoreactive nerves located perivascularly. There was no immunoreactivity in the ligamentum flavum. This study provides further evidence that the facet capsule but not the ligamentum flavum has substantial innervation by sensory and autonomic nerve fibers and has a structural basis for pain perception.
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The distribution of the various classes of immunoglobulins (IG) in synovial membranes in rheumatoid arthritis (RA) and in osteoarthritis (OA) is analyzed. Both plasma cells and extravascular deposits of immunoglobulins are stained using class-specific antisera and the peroxidase-antiperoxidase technique. It can be shown that the local humoral immune response in RA-Synovialitis occurs at a higher level than that of OA; inflammatory infiltrates are denser and plasma cells are activated to a higher degree which is evident in the greater intensity of cytoplasmic staining. While there is no difference in the relation between singular classes of IG in these two groups of diseases, the fraction of plasma cells synthesizing an immunoglobulin is greatly elevated in RA-Synovialitis and there is a correlation of this to the morphological degree of RA-Synovialitis. This applies even more to extravascular deposits of IG with rheumatoid-factor-activity. The determination and staining of extravascular immunoglobulins with a polyvalent anti-human-serum or with antisera specific for the gamma, alpha, and mu-antigens of heavy chains as well as the demonstration of rheumatoid-factor activity of these IG constitute a possibility to histochemically discriminate between RA-Synovialitis and OA-induced synovialitis. In OA, intensely stained areas of IG with rheumatoid-factor-activity located extravascularly are never found.
OBJECTIVE: The purpose of our study was to evaluate the potential of contrast-enhanced MR imaging to detect and to characterize craniocervical rheumatoid arthritis in a large population group, to compare MR imaging with clinical and conventional radiographic findings, and to examine the relationship between the histopathologic and MR imaging findings in seven patients. SUBJECTS AND METHODS: We performed contrast-enhanced MR imaging using T2-weighted gradient-echo sequences and T1-weighted spin-echo sequences in 136 patients with rheumatoid arthritis. Sequential T1-weighted images were obtained before, 3 min after, and 15 min after injection of contrast material. Plain films were acquired in all patients. Serologic status and neurologic status were determined in each patient within 2 days of MR imaging. Patients were categorized into one of four groups, depending upon whether they had joint effusion, hypervascular pannus, hypovascular pannus, or fibrous pannus according to signal patterns on contrast-enhanced MR images. Signal intensity was measured to assess the enhancement of synovial hypertrophy, joint capsule, joint effusion, and the various stages of pannus tissue. Histologic specimens were obtained from seven patients and were correlated with MR imaging findings. RESULTS: Acute and chronic synovitis were differentiated with contrast-enhanced MR imaging as follows: joint effusion (n = 29), hypervascular pannus (n = 54), hypovascular pannus tissue (n = 8), and fibrous pannus (n = 22). Signal intensity differed significantly among the four groups on contrast-enhanced T1-weighted images. In 59 patients with effusion or hypervascular pannus tissue, atlantoaxial subluxation was diagnosed with plain films. Patients with negative findings on radiographic studies (n = 20) had joint effusion, hypervascular pannus tissue, hypovascular pannus formation, or fibrous pannus tissue on MR imaging studies. Cord compression was found in 10% of all cases and isolated sac compression in 16%. Neurologic findings showed no correlation with MR imaging features. CONCLUSION: Contrast-enhanced T1-weighted spin-echo MR imaging can discriminate between joint effusion and various forms of pannus in patients with rheumatoid arthritis of the craniocervical region. MR imaging also can detect joint effusion and pannus tissue in patients with negative radiographic findings. No relationship between MR imaging findings and clinical symptoms were found. Tissue enhancement and histopathologic findings correlated in a limited number of autopsies.