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PubMed2005

Lipid peroxidation and antioxidant enzymes in synovial fluid of patients with primary and secondary osteoarthritis of the knee joint.

OBJECTIVE: Osteoarthritis of the knee (KOA) is a common, age-related, joint disorder associated with loss of articular cartilage, osteophyte formation, sub-chodral bone change and synovitis. Recent studies have shown that reactive oxygen species (ROS) may participate in the initiation and progression of KOA. This study examines potential changes in the activities of antioxidant enzymes (superoxide dismutase, both isoenzymes zinc-copper superoxide dismutase and manganese superoxide dismutase) and glutathione transformation enzymes (glutathione peroxidase, glutathione reductase and glutathione-S-transferase) in synovial fluid of KOA patients, and estimates their relationship to the degree of lipid peroxidation in synovial fluid evaluated by malondialdehyde concentration, synovial fluid viscosity, type and duration of KOA. DESIGN: Synovial fluid samples obtained by transdermal arthrocentesis from 41 patients with KOA (23 had primary KOA and 18 had secondary KOA) and 22 control subjects were analyzed. Activities of antioxidant enzymes were analysed with the use of kinetic method, MDA concentration was measured fluorometrically by the Ohkawa method, and synovial fluid viscosity was measured using a cone-late viscometer Brookfield DV-II+ and a test by Ropes. RESULTS: Patients with KOA had significantly increased activities of all enzymes when compared to the control subjects for both KOA subgroups. The synovial fluid viscosity was significantly decreased and the synovial fluid test by Ropes was abnormal in KOA patients, mainly in the secondary KOA subgroup. The activities of all antioxidant enzymes were significantly negatively correlated with synovial fluid viscosity and duration of KOA. CONCLUSIONS: Patients with KOA display abnormal antioxidant status of synovial fluid with increased activities of antioxidant enzymes and decreased synovial fluid viscosity. Furthermore, synovial fluid viscosity, and activity of GR can be used to distinguish the primary from the secondary type of KOA.

Adult↗
PubMedDate not supplied

[Cytophotometric DNA measurements in mononuclear round cells of synovial fluid].

Cytophotometric investigations were performed on synovial fluid mononuclear round cells in patients with various joint diseases. In nearly all instances only round cells with a diploid DNA-content were found. No increased proliferation could be observed neither in patients with rheumatoid arthritis nor in patients with a high relative number of neutrophilic granulocytes in the synovial fluid.

Arthritis, Rheumatoid↗
PubMed1988

Synovial fluid--its mass, macromolecular content and pressure in major limb joints of the rabbit.

Synovial fluid from rabbit elbow, shoulder, hip and knee was analysed to establish the normal levels of parameters relevant to fluid exchange viz. fluid mass per joint, hydraulic pressure, temperature, colloid osmotic pressure (COP), protein, albumin and glycosaminoglycan (GAG) concentrations. Fluid mass was greatest in the least congruous joint, the shoulder (43 +/- 4 mg), cf. 6 +/- 2 mg in the highly congruous hip. In the knee (24 +/- 4 mg) the mean thickness of the fluid layer was calculated to be 30 microns. Fluid pressure was subatmospheric in all joints (mean -2.8 +/- 0.4 cmH2O, elbow, to -5.7 +/- 0.3 cmH2O, knee), as in many other interstitial spaces. Colloid osmotic pressure was substantial (mean 11.4 +/- 0.9 cmH2O, shoulder, to 13.1 +/- 1.0 cmH2O, elbow), being 40-46% of serum level. Comparison of synovial fluid results with COP versus concentration curves in vitro indicated that the fluid's COP was primarily generated by its protein content (22-30 g l-1, 64% albumin) rather than GAG (4.0-5.8 g l-1). The GAG was 95% hyaluronate and 5% sulphated GAG. Algebraic summation of the hydraulic and colloid osmotic pressures of synovial fluid and serum indicated a net filtration gradient from blood to joint cavity. When serum COP was reduced by intravenous saline infusion, synovial fluid mass increased, in accordance with the ultrafiltration hypothesis of synovial fluid formation. The fluid's colloid concentration declined as volume increased. The relation was not a simple dilution curve, but indicated that the newly formed synovial fluid contained greater than or equal to 8 g protein l-1 (14.5% serum concentration); and that hyaluronate was entering the synovial cavity at a rate of greater than or equal to 6.5 micrograms h-1 per joint.

Animals↗
PubMed1998

Physical, biochemical and cytologic properties of blood and synovial fluid in clinically normal adult camel (Camelus dromedarius).

Forty-three adult one-humped Iranian camels (Camelus dromedarius) were studied to determine their physical, cellular and biochemical parameters of synovial fluid and blood. All the animals were clinically normal with no clinical signs of locomotion problem. Synovial fluid samples were taken from both elbow joints, and blood samples were also obtained from the jugular vein immediately prior to arthrocentesis. The synovial fluid appeared pale, creamy, and clear with no debris. No clot formation was observed at room temperature. Mucin clot test in all samples was normal. The percentage of neutrophils and eosinophils in the synovial fluid was lower than that in blood (P < 0.05). In contrast, the percentage of lymphocytes and monocytes in the synovial fluid was higher than that in blood (P < 0.05). The concentration of protein, glucose, uric acid, inorganic phosphorus, calcium, sodium, potassium, magnesium and the activities of AST, ALT, ALP, CK and LDH was higher in the serum than in the synovial fluid (P < 0.05). Nonetheless, the concentration of chloride in the synovial fluid was higher than in the serum (P < 0.05). The concentration of urea nitrogen in the synovial fluid was similar to that of the serum. Comparing the values of the synovial fluid constituents of the left and the right elbow joint showed that there was no significant difference in any of the physical, cellular and biochemical parameters. No significant difference was found in any of the cellular and biochemical parameters of male and female camels' blood except in red blood cell counts, which was lower in females than in males. Comparing the values of the synovial fluid of male and female camels showed that there was no significant difference in any of the physical, cellular and biochemical parameters.

Animals↗
PubMed1989

[Concentrations of ibuprofen and the protein and pH value of synovial fluid and plasma following oral administration of ibuprofen in patients with arthritis].

Concentrations of Ibuprofen and Protein Concentration and pH-Value in Synovial Fluid and Plasma Following Oral Administration of Ibuprofen in Patients Suffering from Arthritis. In 16 patients suffering from arthritis of the knee the concentration of ibuprofen in the synovial fluid was examined in correlation with the synovial fluid volume, cell count, pH value and protein concentration. The mean ibuprofen concentration in plasma 4 h after oral administration of 400 mg ibuprofen amounted to 15.45 micrograms/ml, the concentration in the synovial fluid was 9.4 micrograms/ml. Due to the inflammatory nature of the effusions the protein concentration in the synovial fluid was evidently increased to an average of 4.46 g/dl and thus was about 65% of the mean plasma protein concentration of 6.88 g/dl. The ibuprofen in the synovial fluid showed a correlation to the protein concentration. On the other hand, there were no significant differences between the pH value in the plasma and in the synovial fluid. There was no tendency to an acid pH. Furthermore, there was no correlation between ibuprofen concentration and cell count. The tests showed that the "accumulation" of the nonsteroidal antiinflammatory drug in the synovial fluid is positively correlated with the high protein concentration but not with the pH value.

Administration, Oral↗
PubMed1983

Synovial fluid and blood monocyte influence on lymphocyte proliferation in rheumatoid arthritis and traumatic synovitis.

The influence of synovial fluid and blood monocytes on autologous lymphocyte proliferation in vitro was investigated in patients with rheumatoid arthritis (RA) and traumatic synovitis (TS). In cultures stimulated with PHA, PWM and ConA, thymidine incorporation by RA blood mononuclear cells (BMC) increased considerably in most cases after addition of 10% or 30% synovial fluid monocytes and a similar effect was seen after stimulation with Candida extract or PPD. A comparable helper activity was observed after addition of synovial fluid monocytes to monocyte-depleted blood cells in RA. The augmenting effect of synovial fluid monocytes was likewise demonstrated in TS patients. Synovial fluid mononuclear cells (SMC) from RA and TS patients displayed low proliferative responses to PHA and ConA in comparison with BMC, while the responses to microbial antigens were similar or greater. The proliferative activity of SMC or of monocyte-depleted synovial fluid cells after polyclonal and antigenic stimulation was not affected by addition of blood monocytes. This was observed in both RA and TS patients. It is concluded that the regulatory properties of synovial fluid monocytes in RA and TS do not explain the low proliferative responses of SMC to polyclonal activators.

Adult↗
PubMed2004

TSG-6 and calcium ions are essential for the coupling of inter-alpha-trypsin inhibitor to hyaluronan in human synovial fluid.

OBJECTIVE: To investigate the role of tumor necrosis factor stimulated gene 6 (TSG-6) and metal ions in the coupling of inter-alpha-trypsin inhibitor (ITI) to hyaluronan in human synovial fluid. DESIGN: The concentration of ITI heavy chains bound to hyaluronan was determined by a two-step electrophoretic technique. Synovial fluid, TSG-6 depleted synovial fluid and metal chelated synovial fluid were tested for their ability to support the coupling of ITI heavy chains to hyaluronan. RESULTS: When synovial fluid was mixed with an ITI-source (serum or purified ITI), coupling of ITI heavy chains to hyaluronan took place. TSG-6 immunodepleated synovial fluid lost the coupling activity, but addition of recombinant TSG-6 restored the activity. EDTA inhibited the coupling activity, but combinations of the metal-ion chelators Mg-EGTA and Ca-EGTA demonstrated, that Ca++ is essential for the coupling of ITI heavy chains to hyaluronan. CONCLUSIONS: Tumor necrosis factor stimulated gene 6 (TSG-6) and calcium ions are both essential for the coupling of inter-alpha-trypsin inhibitor to hyaluronan in human synovial fluid.

Alpha-Globulins↗
PubMed1977

Naproxen concentrations in serum, synovial fluid, and synovium.

Naproxen levels in serum, synovial fluid and synovium of eighteen patients with "classical" or "definite" rheumatoid arthritis and chronic knee effusion were studied. After oral administration of 250 mg naproxen twice daily, naproxen levels in synovial fluid were found to be more than half as high as in serum. Even in synovium itself naproxen levels were appreciable.

Administration, Oral↗
PubMed1975

N-acetyl-beta-d-glucosaminidase activity in synovial fluid.

N-acetyl-beta-D-glucosaminidase activity in the synovial fluid of different articular diseases was studied and statistical investigations were carried out after logarithmic transformation of the data. The enzyme activity in the synovial fluid of rheumatoid arthritis is increased when compared with osteoarthrosis and traumatic effusions. The enzyme activity in traumatic effusions is also increased in comparison with osteoarthrosis. A linear relation was found between the enzyme activity in cell-free fluid and the polymorphonuclear leucocyte (PMN) count in rheumatoid arthritis osteoarthrosis and in miscellaneous synovitis. The activity per PMN cell was determined and found to be relatively constant in the synovial fluid of inflammatory diseases (rheumatoid arthritis, chondrocalcinosis, miscellaneous synovitis). The N-acetyl-beta-D-glucosaminidase activity per PMN cell in serum was found to be significantly lower than in synovial fluid.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Synovial fluid analysis in cattle: a review of 130 cases.

OBJECTIVE: To compare synovial fluid characteristics of cattle with infectious and noninfectious arthritis. STUDY DESIGN: Retrospective cohort study. ANIMAL OR SAMPLE POPULATION: 130 cattle. METHODS: Synovial fluid was analyzed for total nucleated cell count (NCC), absolute number and percentages of polymorphonuclear (PMN) and mononuclear cells, total protein (TP) concentration, and specific gravity. Cattle were categorized as having infectious or noninfectious arthritis based on physical and lameness examinations, joint radiographs, and microbial culture results. Kruskal-Wallis 1-way analysis of variance was used to compare synovial fluid analysis data from different categories. Selection of cut-off values for the calculation of likelihood ratios, sensitivity, specificity, and positive and negative predictive values was based on examination of the distribution of the data using histograms. RESULTS: Cattle with infectious arthritis had significantly higher numbers of total NNC, PMN cells, TP concentration, and specific gravity (P = .0001) and a significantly higher percentage of PMN cells compared with cattle with noninfectious arthritis (P = .0001). The percentage of mononuclear cells was significantly higher in cattle with noninfectious arthritis (P = .0001). CONCLUSIONS: Synovial fluid analysis is useful for differentiation of infectious and noninfectious causes of joint disease in cattle. CLINICAL RELEVANCE: Cattle with a synovial fluid total NCC > 25,000 cells/microL, a PMN cell count > 20,000 cells/microL or more than 80% PMN cells, and TP > 4.5 g/dL should be considered to have infectious arthritis.

Animals↗
PubMedDate not supplied

Complement activation products and factors influencing phagocyte migration in synovial fluids from children with chronic arthritis.

Synovial fluids from children with chronic arthritis were examined simultaneously for the presence of complement activation products and factors affecting phagocyte migration. The concentrations of C3a and C5a, but not C4a, were found to be elevated relative to normal plasma. However, the C3a and C5a concentrations in synovial fluid did not correlate with C1q binding values or with degree of migration inhibition or chemoattraction caused by that fluid. Although this data implies complement activation occurs in inflamed joints in juvenile arthritis, the specific role of immune complexes remains unproven.

Arthritis, Juvenile↗
PubMed2006

Gentamicin concentrations in synovial fluid and joint tissues during intravenous administration or continuous intra-articular infusion of the tarsocrural joint of clinically normal horses.

OBJECTIVE: To compare gentamicin concentrations achieved in synovial fluid and joint tissues during IV administration and continuous intra-articular (IA) infusion of the tarsocrural joint in horses. ANIMALS: 18 horses with clinically normal tarsocrural joints. PROCEDURE: Horses were assigned to 3 groups (6 horses/group) and administered gentamicin (6.6 mg/kg, IV, q 24 h for 4 days; group 1), a continuous IA infusion of gentamicin into the tarsocrural joint (50 mg/h for 73 hours; group 2), or both treatments (group 3). Serum, synovial fluid, and joint tissue samples were collected for measurement of gentamicin at various time points during and 73 hours after initiation of treatment. Gentamicin concentrations were compared by use of a Kruskal-Wallis ANOVA. RESULTS: At 73 hours, mean +/- SE gentamicin concentrations in synovial fluid, synovial membrane, joint capsule, subchondral bone, and collateral ligament of group 1 horses were 11.5 +/- 1.5 microg/mL, 21.1 +/- 3.0 microg/g, 17.1 +/- 1.4 microg/g, 9.8 +/- 2.0 microg/g, and 5.9 +/- 0.7 microg/g, respectively. Corresponding concentrations in group 2 horses were 458.7 +/- 130.3 microg/mL, 496.8 +/- 126.5 microg/g, 128.5 +/- 74.2 microg/g, 99.4 +/- 47.3 microg/g, and 13.5 +/- 7.6 microg/g, respectively. Gentamicin concentrations in synovial fluid, synovial membrane, and joint capsule of group 1 horses were significantly lower than concentrations in those samples for horses in groups 2 and 3. CONCLUSIONS AND CLINICAL RELEVANCE: Continuous IA infusion of gentamicin achieves higher drug concentrations in joint tissues of normal tarsocrural joints of horses, compared with concentrations after IV administration.

Animals↗
PubMed1982

Protease inhibitors in rheumatoid synovial fluid. Analyses of electrophoretic homogeneity and protease inhibitory capacity.

Paired plasma and synovial fluids from 17 patients with seropositive rheumatoid arthritis were examined for electrophoretic homogeneity/heterogeneity and enzymic inhibitory capacity of the protease inhibitors. The high degree of saturation (approximately 90%) of the polyvalent protease inhibitor alpha 2-macroglobulin in the rheumatoid synovial fluid contrasts sharply with the low saturation of alpha 1-anti-trypsin. The inhibitory reactivity of the non-complexed fraction of both of these dominating antiproteases was retained (approximately 85-90%). Thus, a selective inactivation of synovial alpha 1-antitrypsin could not be demonstrated. alpha 1-Anti-chymotrypsin revealed electrophoretic homogeneity in all synovial fluids. Electrophoretic heterogeneity of the plasmin inhibitor antiplasmin was detected in the majority of synovial fluids indicating plasmin activation. The existence of a protease-antiprotease imbalance in the rheumatoid joint was indicated by the high degree of saturation of alpha 2-macroglobulin and a cleavage of C3 in rheumatoid synovial fluids.

Arthritis, Rheumatoid↗
PubMed1979

Immune complexes in rheumatoid arthritis sera and synovial fluids: a comparison of three methods.

Sera and synovial fluids from 88 patients with rheumatoid arthritis were examined for circulating immune complexes by three assays: monoclonal rheumatoid factor radioimmunoassay, C1q binding assay, and Raji cell radioassay. Paired samples were available for 82 patients. Immune complexes were detected with high frequency in the synovial fluid by each assay (75% by the monoclonal rheumatoid factor radioimmunoassay, 95% by the C1q binding assay, and 61% by the Raji cell readioassay). In rheumatoid arthritis sera, immune complexes were detected with high frequency by the C1q binding assay (85%) and the monoclonal rheumatoid factor radioimmunoassay (70%) but infrequently by the Raji cell radioassay (26%). The presence of immune complexes in serum was most frequently accompanied by the presence of complexes in fluid, regardless of the method of detection; moreover, the levels of immune complexes in synovial fluid were generally higher than in paired serum. Further, the levels of immune complexes as measured by the C1q binding assay correlated with certain parameters of clinical activity, while the monoclonal rheumatoid factor radioimmunoassay and Raji cell radioassay correlated with extraarticular features (excluding nodules) of rheumatoid arthritis.

Antigen-Antibody Complex↗
PubMed1987

2 dimensional flow cytometric analysis of activation antigens expressed on the synovial fluid T cells in rheumatoid arthritis.

Synovial fluid T cells expressed a higher percentage of all 3 activation antigens examined (anti-Ia antigen [HLA-DR]; antiinterleukin 2 receptor antigen [Tac], and antitransferrin receptor [TF-R] antigen) than the paired peripheral blood T cells obtained simultaneously from 19 patients with rheumatoid arthritis (RA) (p less than 0.001-0.05). A highly significant correlation was observed between disease activity and the percentage of Tac+ T cells in the synovial fluid from patients with RA (p less than 0.001).

Adult↗
PubMed1977

Correlation between levels of breakdown products of C3, C4, and properdin factor B in synovial fluids from patients with rheumatoid arthritis.

Synovial fluids from 31 patients with seropositive rheumatoid arthritis (RA) and 23 patients with seronegative RA had significantly increased levels of breakdown products to C3, C4, and properdin factor B when compared to patients with osteoarthritis (OA) (P less than 0.01). The same patients exhibited a considerable overlap of native C3, C4, and properdin factor B levels when their results were compared with those of OA patients. The parallel increase of C3d, C4d, and Ba levels in patients with RA suggests an activation of the complement system rather than a nonspecific enzymatic breakdown in synovial fluids.

Arthritis, Rheumatoid↗
PubMed1988

Biological characterization of T cell-replacing factor in the synovial fluid of rheumatoid arthritis patients.

The synovial fluid of patients with rheumatoid arthritis (RA) contains a biologically active factor which has the ability to replace T cells for the induction of antibody secretion by human blood lymphoid cells stimulated by pokeweed mitogen (PWM) in vitro. This factor, which will be referred to as RA-SF (synovial fluid), also has the capacity to act as a B cell-stimulatory factor of mouse splenic lymphocytes in the presence of lipopolysaccharide (LPS). Using a test system developed for the definition of interleukin 4 (IL-4), which is a B cell-stimulating lymphokine which preferentially activates the synthesis of selected Ig classes in mouse lymphoid cells, we have shown that RA-SF has properties similar to IL-4 in that it induces differentiation of antibody secretion in the LPS-pretreated mouse cell, but unlike IL-4, which gives IgG1 and IgE, it selectively induces IgG2b synthesis. The present study demonstrates that RA-SF has a biological activity that is reminiscent of other B cell-stimulating mouse lymphokines, but it is biologically distinct from IL-2, IL-4, and IL-5. Recent data also indicate that it is distinct from gamma interferon (IFN-gamma). Therefore, we conclude that the biological activity of RA-SF has properties in common with a T-cell replacing (TRF) and B-cell differentiation factor (BCDF) and probably represents yet another biological activity which so far lacks an experimental counterpart. The relevance of this factor for autoantibody synthesis is discussed.

Animals↗
PubMed1997

Soluble oligonucleosomal complexes in synovial fluid from inflamed joints.

OBJECTIVE: To determine whether soluble oligonucleosomal DNA, typical of that released during apoptotic cell death, is present in synovial fluids from inflamed joints and, if so, whether it is present in sufficient concentrations to have pathophysiologic significance. METHODS: Fifty synovial fluid specimens from 46 patients were studied, 41 from joints with a variety of inflammatory disorders and 9 from osteoarthritic joints. DNA from freshly collected synovial fluid was isolated and quantitated by microfluorometry, and the oligonucleosomal fraction was measured by radiolabeling, gel electrophoresis, and autoradiography. Specific immunoprecipitation with monoclonal antihistone antibody, after DNA radiolabeling in whole synovial fluid, was used to detect histone binding. RESULTS: DNA with a typical oligonucleosomal ladder was observed in most specimens. The mean +/- SD oligonucleosomal DNA concentration was 14.1 +/- 18.5 microg/ml in synovial fluids from inflamed joints, considerably higher than that in osteoarthritic synovial fluids. Additionally, the DNA was shown to be complexed with histone, as would be expected. Control experiments were performed to show that the oligonucleosomal DNA was present in soluble form and did not arise due to in vitro artifact. The DNA concentrations were found to correlate significantly with the concentrations of synovial fluid leukocytes, most of which were neutrophils. CONCLUSION: Synovial fluids from inflamed joints contain oligonucleosomal DNA typical of that released during apoptotic cell death. The probable source is fluid-phase neutrophils undergoing apoptotic cell death, although this was not directly demonstrated. The concentrations are sufficient to have biologic activity similar to that shown in vitro, including lymphoproliferation and stimulation of interleukin-6 secretion. A mechanism by which oligonucleosomal DNA may contribute to perpetuation of rheumatoid synovitis is proposed. If it is generalizable to other sites of inflammation, as seems probable, similar oligonucleosomal DNA release accompanying inflammation may play a pathogenetic role in other disorders, including systemic lupus erythematosus.

DNA↗