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PubMedDate not supplied

Application of a novel protein biochip technology for detection and identification of rheumatoid arthritis biomarkers in synovial fluid.

We compared protein profiles of the synovial fluid of patients with rheumatoid arthritis and osteoarthritis by using surface-enhanced laser desorption/ionization mass spectrometry technology. With this approach, we identified a protein expressed specifically in the synovial fluid of the patients with rheumatoid arthritis. During the investigation, we found several reproducible and discriminatory biomarker candidates for distinction between rheumatoid arthritis and osteoarthritis. Among these candidates, a 10 850 Da protein peak was the clearest example of a single signal found specifically in the rheumatoid arthritis samples. This candidate was purified using a size-exclusion spin column followed by gel electrophoresis and subsequently identified by peptide mapping and post-source decay (PSD) analysis. The results clearly indicate that the protein is myeloid-related protein 8, which was verified by the enzyme immunoassay. It is known that the myeloid-related protein 8 level in serum and synovial fluid is related to disease activity in juvenile rheumatoid arthritis. The results suggest that the ProteinChip platform is useful to detect and identify protein biomarkers expressed specifically in diseases or in some stage of diseases.

Arthritis, Rheumatoid↗
PubMed1990

Concentrations of glycosaminoglycans in synovial fluids and their relation with immunological and inflammatory mediators in rheumatoid arthritis.

The dimethylmethylene blue assay showed higher concentrations of glycosaminoglycans in many synovial fluids from patients with rheumatoid arthritis (RA) than in autologous sera or sera or synovial fluids from normal subjects. These results were taken to suggest that the glycosaminoglycans in RA synovial fluid were abnormally raised and derived from cartilage. To discover what stimulated such glycosaminoglycan release in RA joints relations were sought between synovial fluid concentrations of glycosaminoglycans and immunological and inflammatory mediators. It was shown that RA synovial fluid glycosaminoglycan concentrations correlated with synovial fluid C3d concentrations but not with synovial fluid rheumatoid factor concentrations, polymorphonuclear leucocyte numbers, myeloperoxidase concentrations, or the ability of the synovial fluids to release free radicals from normal polymorphonuclear leucocytes. A correlation was found between synovial fluid C3d and interleukin 1 concentrations as judged by both lymphocyte activating factor activity and immunoassay, but no significant correlation was detected between interleukin 1 and glycosaminoglycan concentrations. It is suggested that in the rheumatoid joint locally produced cytokines, in addition to interleukin 1, together stimulate glycosaminoglycan release from cartilage and render it vulnerable to attack by other processes.

Adult↗
PubMed1988

The aminoterminal-type-III procollagen peptide and proteoglycans in serum and synovial fluid of patients with rheumatoid arthritis or reactive arthritis.

The concentrations of aminoterminal-type-III procollagen (procollagen N-) peptide, and of proteoglycans were measured in knee-joint synovial fluid and serum from patients with rheumatoid arthritis or reactive arthritis. All synovial fluids contained large amounts of intact propeptide. The synovial fluid: serum propeptide ratios were high, suggesting local propeptide liberation. A correlation was demonstrated between the propeptide concentration in synovial fluid and in serum. In rheumatoid arthritis, the propeptide concentration in synovial fluid was related to local inflammatory activity, and the serum concentration was correlated with the presence of nonspecific markers of inflammation. The presence of smaller propeptide fragments in synovial fluid indicated that some degradation occurred locally. The local metabolic changes were most prominent in patients with joint erosions. Patients with nonerosive rheumatoid arthritis and reactive arthritis had similar synovial fluid propeptide concentrations. The proteoglycan content of synovial fluid was inversely related to the degree of joint destruction, and was highest in patients with reactive arthritis. No correlation was observed between the concentrations of propeptide and proteoglycan in synovial fluid. Intraarticular glucocorticoid injection reduced the levels of propeptide and proteoglycan in synovial fluid.

Adult↗
PubMed1985

Synovial fluid kinetics of non-steroidal anti-inflammatory drugs.

Synovial fluid kinetics of NSAIDs are still in a relatively nascent stage. These kinetics are determined by the biochemical characteristics of the drugs, the characteristics of the synovium, and the characteristics of the host. NSAIDs show a delayed peak concentration (relative to serum) in the synovial fluid, and their terminal synovial half-lifes generally parallel the serum half-life. Their intrasynovial concentrations are determined to a large extent by synovial fluid protein concentrations plus diffusional barriers to ingress and egress, although displacing substances (including other drugs), and disease, may complicate kinetics. The synovial pharmacodynamic of NSAIDs are understood very poorly. Hopefully a better understanding of synovial fluid and tissue kinetics will lead to more rational therapy with NSAIDs in the future.

Anti-Inflammatory Agents↗
PubMed1987

Synovial fluid lipid abnormalities in various disease states: review and classification.

Although lipids are not usually present in large quantities in normal synovial fluids or in the usual synovial fluid seen in most rheumatologic conditions, their presence in synovial fluid may have diagnostic importance. As summarized in Table 2, analysis of synovial fluids for lipid constituents is relatively simple. On standing or after centrifugation, significant amounts of lipids may layer out and be visible as a supernatant. On microscopic examination, lipid droplets are usually easily seen and should be stainable with appropriate dyes (oil red O or Sudan III or IV), or may occasionally be visualized as intracellular or extracellular inclusions by polarized microscopy. Small (0.5 to 2.0 microns) intracellular inclusions containing triglycerides may be seen in neutrophils from most synovial fluids, and are of no diagnostic importance. Cholesterol crystals may be readily recognized microscopically by their characteristic flat, plate-like appearance and notched corners Synovial fluid may also be analyzed for cholesterol and triglycerides in routine clinical laboratories, and free fatty acids and lipolytic enzymes in special lipid laboratories. The presence of massive increases in cholesterol associated with microscopically visible cholesterol crystals is usually associated with chronic RA, occasionally in the setting of super-imposed bacterial infection. The presence of gross or microscopic lipid droplets is usually associated with trauma and hemorrhagic effusions. When present in this setting, the clinician should entertain a high suspicion for a significant intraarticular injury, such as fracture, meniscal tear, or severe ligamentous injury. In addition, however, several instances of non-traumatic inflammatory effusions associated with intracellular and extracellular lipid droplets have been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesterol↗
PubMed2000

Prevalence and relevance of antibodies to type-I and -II collagen in synovial fluid of dogs with cranial cruciate ligament damage.

OBJECTIVE: To measure and compare synovial fluid antibody titers to type-I and -II collagen in stifle joints with instability caused by complete or partial cranial cruciate ligament (CCL) rupture and joints with osteoarthrosis secondary to other pathologic changes in dogs. ANIMALS: 82 dogs with diseased stifle joints. PROCEDURE: Synovial fluid samples were collected from 7 dogs with clinically normal stifles (control group) and 82 dogs with diseased joints (50 stifle joints with complete rupture of the CCL, 20 with partial damage of the CCL, and 12 joints with radiographic signs of osteoarthritis secondary to other arthropathies). Synovial fluid samples were tested for autoantibodies to type-I and -II collagen by an ELISA. RESULTS: In dogs with complete and partial CCL rupture, synovial fluid antibody titers to type-I and -II collagen were significantly increased, compared with control dogs. Forty-eight percent (24/50) of samples from dogs with complete CCL rupture and 35% (7/20) of samples from dogs with partial CCL rupture had antibody titers to type-I collagen that were greater than the mean plus 2 standard deviations of the control group titers. Synovial fluid antibody titers to type-II collagen were high in 40% of the dogs with partial or (8/20) complete (20/50) CCL rupture. Dogs with osteoarthrosis secondary to other pathologic changes had significantly increased synovial fluid antibodies to type-I and -II collagen, compared with control dogs. CONCLUSION: Increases in autoantibodies to collagen in synovial fluid are not specific for the type of joint disorder. It is unlikely that the anticollagen antibodies play an active role in the initiation of weakening of the CCL.

Animals↗
PubMed1978

Somatomedin activity in synovial fluid from patients with joint diseases.

The somatomedin activity in synovial fluids from 50 patients with a variety of joint diseases has been studied and compared with the activity in each of the patient's own serum and a standard reference serum (SRS). The porcine costal cartilage bioassay of Van den Brande and Du Caju (1974a) has been used with the isotopes 3H-thymidine and 35S-sulphate. Synovial fluids from most patients with post-traumatic and post-operative effusions, osteoarthritis and arthritis associated with psoriasis, Reiter's disease, and ankylosing spondylitis stimulated the synthesis of DNA and proteoglycans in cartilage. Synovial fluids from patients with rheumatoid arthritis either had impaired capacity to stimulate DNA synthesis, or they inhibited it; a similar, but less evident pattern was observed for proteoglycan synthesis. Some synovial fluids from patients with miscellaneous synovitides stimulated, while others inhibited cartilage metabolism. It is concluded that the synovial fluid from patients with rheumatoid arthritis and from some patients with miscellaneous synovitides contained an inhibitor(s) to DNA and possibly proteoglycan synthesis. The sera from nearly all the patients stimulated both DNA and proteoglycan synthesis, but the somatomedin potency ratios for serum in terms of SRS were generally less than 1.0. There was a significant inverse correlation between the serum somatomedin potency ratio and the age of the patient.

Adolescent↗
PubMed1999

The effect of phospholipase digestion upon the boundary lubricating ability of synovial fluid.

OBJECTIVE: To identify the boundary lubricant in synovial fluid (SF). Is synovial lubrication mediated by surface active phospholipid as opposed to mucinous glycoprotein? METHODS: A sonicated preparation of phosphatidylcholine and bovine SF were tested in vitro in a bearing of latex oscillating against polished glass under a load of 0.35 x 10(6) N/m2. The friction apparatus isolates conditions of boundary lubrication and has been validated against a cartilaginous bearing. Coefficient of friction (mu) was measured and compared against mu from physiologic saline, which served as a control. Separate digestions were carried out upon the SF with trypsin, phospholipase C, and phospholipase A2 in the presence and absence of proteolytic inhibitors. RESULTS: Digestions of bovine SF by phospholipase C in the presence of protease inhibitors did not remove boundary lubricating ability compared to an undigested control (p = 0.89). Digestion of bovine SF with trypsin removed all lubricating ability and raised friction (p = 0.004). Commercial purified phospholipase C contained trypsin-like activity when activity was tested with N alpha-benzoyl-L-arginine ethyl ester as substrate. Similar results were observed for phospholipase A2, which possesses a lower amount of trypsin activity. CONCLUSION: The results indicate that phospholipid does not play a prominent role in synovial fluid's ability to lubricate an artificial bearing. Rather, the boundary lubricating ability of SF is attributable to lubricin, a mucinous glycoprotein.

Animals↗
PubMed1983

Synovial fluid inhibits killing of Staphylococcus aureus by neutrophils.

Serum in the extracellular environment promotes neutrophil bactericidal activity apart from its opsonizing properties. We examined the effect of non-inflammatory osteoarthritic synovial fluid on serum-mediated neutrophil killing of Staphylococcus aureus. This was done to evaluate the effect of synovial fluid on neutrophil bactericidal activity independent of opsonin concentration. With an initial inoculum of 5 X 10(6) CFU/ml, 1.47 +/- 0.14% bacteria survived after 120 min of incubation with 10% serum and neutrophils. In contrast, 4.07 +/- 0.33% bacteria survived after incubation in serum plus synovial fluid (P less than 0.001). This inhibitory effect was directly related to the concentration of synovial fluid in the incubation mixture. Increasing the concentration of synovial fluid resulted in an increased percent survival. Studies utilizing preopsonized bacteria and radiolabeled organisms demonstrated that synovial fluid did not interfere with opsonization or phagocytosis. Intracellular bactericidal activity was assayed separately from phagocytosis by utilizing a brief ingestion period followed by the removal of extracellular bacteria by either differential centrifugation or lysostaphin treatment. The reincubation of cells and associated bacteria with serum or serum plus synovial fluid revealed that synovial fluid significantly inhibited the promoting effect of serum on neutrophil bactericidal activity. After 60 min of incubation with 10% serum, 13.0 +/- 1.2% bacteria survived, whereas 21.5 +/- 2.3% survived after incubation in serum plus synovial fluid (P less than 0.005). Superoxide production was not affected by the presence of synovial fluid. These findings suggest that the inhibitory effect of synovial fluid is due to an interaction between synovial fluid and the serum factors that promote intracellular killing.

Blood Bactericidal Activity↗
PubMed1999

Whipple's arthritis: direct detection of Tropheryma whippelii in synovial fluid and tissue.

We describe 2 patients presenting with polyarthritis in whom the synovial fluid (1 patient) or synovial tissue (1 patient) was positive for Tropheryma whippelii, the Whipple's disease-associated bacillus, when examined by polymerase chain reaction (PCR) and DNA sequencing. Histopathologic findings were consistent with articular Whipple's disease in the synovial fluid of 1 patient and the synovial tissue of the other. In both patients, bowel mucosal specimens were negative for Whipple's disease features by histologic and PCR methods. One patient was positive for T whippelii in the peripheral blood. Control synovial fluid specimens from 40 patients with other arthritides, including Lyme arthritis, were negative. Sequencing of a 284-basepair region of the 16S ribosomal RNA gene confirmed that the sequence is closely related to the known T whippelii sequence. Both patients responded to treatment with antibiotics.

Actinobacteria↗
PubMed1996

Thrombin in the synovial fluid of patients with rheumatoid arthritis mediates proliferation of synovial fibroblast-like cells by induction of platelet derived growth factor.

OBJECTIVE: To investigate the clotting and fibrinolytic activities in synovial fluid (SF) from patients with rheumatoid arthritis (RA) and to examine the role of thrombin in synovial hyperplasia. METHODS: We measured the amounts of thrombin-antithrombin-III complex (TAT), antithrombin-III (AT-III), thrombin, plasminogen, alpha 2-plasmin inhibitor (alpha 2-PI), and plasmin-alpha 2-antiplasmin complex (PAP) in SF of 20 patients with RA and 16 patients with osteoarthritis (OA). The proliferative response of synovial fibroblast-like cells to thrombin was measured using [3H] thymidine incorporation. Expression of platelet derived growth factors (PDGF) in conditioned medium was analyzed using a Western blot method, and expression of the mRNA of PDGF and their receptors was analyzed by reverse transcription polymerase chain reaction. RESULTS: The amounts of clotting factors (TAT, AT-III) and fibrinolytic factors (plasminogen, alpha 2-PI, and PAP) were significantly higher in the patients with RA than in patients with OA (p < 0.01). Moreover, SF thrombin concentrations of patients with RA correlated significantly with erythrocyte sedimentation rates (rs = 0.751, p < 0.01) and serum C-reactive protein concentrations (rs = 0.531, p < 0.05). Thrombin exhibits mitogenic activity toward synovial fibroblast-like cells in vitro, and this mitogenic activity is associated with an increase in the expression of mRNA of both PDGF-alpha receptor and PDGF-beta-receptor. CONCLUSION: The high levels of thrombin activity in the SF of patients with RA and strong mitogenic activity of thrombin toward the synovial fibroblast-like cells suggest that thrombin plays an important role in the pathogenesis of RA.

Adult↗
PubMed1977

Therapeutic use of gentamicin in horses: concentrations in serum, urine, and synovial fluid and evaluation of renal function.

Serum, synovial fluid, and urine concentrations of gentamicin were measured in normal mature horses which had been given a single dose of the drug. Mean peak serum concentration (16.8 microgram/ml) occurred in horses 30 minutes after they were given a single intramuscular dose of 4.4 mg of gentamicin/kg of body weight. In horses given a smaller dose of gentamicin (1.7 mg/kg), mean peak serum concentrations of gentamicin (10.2 microgram/ml) appeared at 1 hour. Synovial fluid concentration was maximum at 2 hours for both doses; in horses given the larger dose, mean peak concentration was 6.4 microgram/ml, and in those given the smaller dose (1.7 mg/kg), 3.4 microgram/ml. Measurable concentrations of gentamicin in serum and synovial fluid persisted 8 hours. During the first 8 hours, percentages of gentamicin excreted in the urine were between 3.9 and 32.8% of the larger dose and between 3.3 and 13.4% of the smaller dose. Serum creatinine concentrations were serially measured in 10 hospitalized horses intramuscularly given 1.7 to 4.4 mg of gentamicin/kg 4 times a day' significant increase in creatinine concentration was not found.

Animals↗
PubMed1997

Effect of normal synovial fluid on the metabolism of articular chondrocytes in vitro.

It is thought that articular cartilage gains most of its nutrition in vivo, via diffusion, from synovial fluid. There have been few studies investigating the effect of synovial fluid on chondrocyte metabolism in vitro. In the current study, bovine articular chondrocytes were isolated and cultured in agarose using normal allogenic synovial fluid as culture medium. Dulbecco's minimal essential medium + 20% fetal calf serum and Earle's balanced salt solution were used as control media. Cell viability at the end of the experiment showed that neither synovial fluid nor Earle's balanced salt solution had a significant effect on viability when compared with Dulbecco's minimal essential medium + 20% fetal calf serum during the period assessed. Results indicate that levels of glycosaminoglycan synthesis can be maintained when Dulbecco's minimal essential medium + 20% fetal calf serum is diluted with Earle's balanced salt solution to levels of 80% Earle's balanced salt solution. When Dulbecco's minimal essential medium + 20% fetal calf serum was diluted with synovial fluid, glycosaminoglycan synthesis was stimulated in a dose dependent manner to 80% synovial fluid. Even at 100% synovial fluid, synthesis levels were significantly higher than for Dulbecco's minimal essential medium + 20% fetal calf serum. Tritiated thymidine uptake decreased with increasing concentrations of either Earle's balanced salt solution or synovial fluid. The results suggest that culture in synovial fluid induces a state similar to that seen in vivo, with high levels of glycosaminoglycan synthesis and low levels of cell division.

Animals↗
PubMed1991

Identification and characterization of opsonic fibronectin in synovial fluids of patients with active rheumatoid arthritis.

A cofactor that selectively opsonizes particulate activators of the human alternative complement pathway and enhances their phagocytosis by human monocytes was identified in synovial fluids of patients with rheumatoid arthritis. The active material was present in fluids treated with protease inhibitors, was heat stable, and was unaffected by incubation with hyaluronidase. Chromatographic isolation of synovial fluid fibronectin by gelatin affinity and by immunoaffinity on antifibronectin monoclonal antibody BD4 yielded similar quantities of protein for each of 3 fluids. Synovial fluid proteins with the BD4 fibronectin epitope accounted for essentially all of the phagocytosis-enhancing activity and expressed this activity by opsonizing target activators. Additional chromatographic analyses of synovial fluid fibronectin with the BD4 epitope were carried out using Sepharose-bearing gelatin and 4 additional antifibronectin monoclonal antibodies. The opsonic materials were characterized as having 2 distinct fibronectin epitopes, which always mapped from the cell adhesive domain to the carboxyl-terminus of plasma fibronectin, but only rarely contained the gelatin binding domain.

Arthritis, Rheumatoid↗
PubMed2006

Concentrations of serum amyloid A in serum and synovial fluid from healthy horses and horses with joint disease.

OBJECTIVE: To determine serum amyloid A (SAA) concentrations in serum and synovial fluid from healthy horses and horses with joint disease and assess the effect of repeated arthrocentesis on SAA concentrations in synovial fluid. Animals-10 healthy horses and 21 horses with various types of joint disease. PROCEDURES: Serum and synovial fluid samples were obtained from each horse. In 5 of the 10 healthy horses, arthrocentesis was repeated 9 times. Concentrations of SAA were determined via immunoturbidometry. RESULTS: Serum and synovial fluid SAA concentrations were less than the assay detection limit in healthy horses and did not change in response to repeated arthrocentesis. Synovial fluid SAA concentrations were significantly higher in horses with suspected bacterial joint contamination or infectious arthritis, or tenovaginitis than in healthy controls, and serum concentrations were significantly higher in horses with infectious conditions than in the other groups. Neither serum nor synovial fluid SAA concentrations in horses with low-inflammation joint conditions differed significantly from those in healthy controls. Concentrations of SAA and total protein in synovial fluid were significantly correlated. CONCLUSIONS AND CLINICAL RELEVANCE: Synovial fluid SAA concentration was a good marker of infectious arthritis and tenovaginitis and appeared to reflect changes in inflammatory activity. The advantages of use of SAA as a marker include the ease and speed of measurement and the fact that concentrations in synovial fluid were not influenced by repeated arthrocentesis in healthy horses. Further study of the SAA response in osteoarthritic joints to assess its usefulness in diagnosis and monitoring of osteoarthritis is warranted.

Animals↗
PubMed1986

Very late activation antigens on rheumatoid synovial fluid T lymphocytes. Association with stages of T cell activation.

Lymphocytes from the synovial fluid of eight out of eight rheumatoid arthritis (RA) patients had elevated very late activation antigen-1 (VLA-1) expression (10-36% positive cells), whereas peripheral blood lymphocytes (PBL) from RA patients and healthy controls had low VLA-1 expression (0-6% positive cells). During 1-2 wk of in vitro culture, VLA-1 increased on synovial fluid cells but remained low on PBL. In comparison, the interleukin 2 receptor (IL-2 R) was less prominent than VLA-1 on fresh synovial fluid cells, did not increase on cultured synovial fluid T cells, but did increase greatly on cultured PBL. The mitogen PHA reversed or prevented the appearance of VLA-1+, IL-2 R- synovial fluid cells during in vitro culture, thus giving IL-2 R+, VLA-1- cells. These results emphasize that VLA-1+ SF cells are different from resting cells or IL-2 R+ activated PBL T cells, and VLA-1 on synovial fluid T cells may be incompatible with mitogen stimulation. In addition, the VLA-2 heterodimer (165,000/130,000 relative molecular mass [Mr]) was regulated opposite to the VLA-1 heterodimer (130,000/210,000 Mr) on synovial lymphocytes, and thus the VLA-1/VLA-2 ratio is another indicator of the stage of T cell activation.

Antigens, Surface↗
PubMed1980

Interpretation of synovial fluid data.

The routine battery of tests for synovial fluid analysis includes culture and Gram staining, polarizing microscopy, and total WBC and differential counts. If the volume of fluid collected is low, culture and polarizing microscopy have highest priority. Synovial fluid data are diagnostic in only two diseases: septic arthritis and crystal-induced arthritis. In traumatic arthritis, degenerative joint disease, rheumatoid arthritis, and systemic lupus erythematosus, synovial fluid data may provide evidence supporting the diagnosis.

Arthritis↗
PubMedDate not supplied

Antigen-induced arthritis: an immunohistologic study of articular tissue and synovial fluid using the horseradish peroxidase technique.

Articular tissue and synovial fluid from rabbits with antigen-induced arthritis were stained for localization of immunoglobulin (Ig) and egg albumin (EA) using the immunoperoxidase technique. Discrete granules containing Ig and EA were initially observed within vascular synovial tissue with later occurrence in synovial fluid and dense connective tissue. Homogeneous staining for Ig was not always associated with the presence of antigen and, therefore, cannot be used alone as evidence of the presence of immune complexes. Discrete granules of Ig and EA are formed in dense connective tissue during the period of maximal inflammation and persist for at least 30 days. These granules presumably represent precipitated immune complexes of Ig and EA but can be stained for Ig alone longer than for EA. Insoluble, particulate immune complexes of Ig and EA appeared in synovial fluid within 2 h after injection and remained at least 24 h. These were identical in appearance to the Ig precipitates occurring in synovial fluids from human rheumatoid arthritis.

Animals↗