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PubMed1975

Virus antibodies in serum and synovial fluid of patients with rheumatoid arthritis and other connective tissue diseases.

Rubella and influenza A (H3N2) haemagglutination inhibition (HI) antibody titres and measles complement-fixing (CF), haemagglutination inhibition (HI), haemolysis inhibition (HLI), and ribonucleoprotein gel precipitation (RNP-GP) antibody titres were studied in the serum and synovial fluid of twenty patients with rheumatoid arthritis (RA), two patients with ankylosing spondylitis, and two patients with Reiter's syndrome. Antibody titres were also studied in the serum and CSF of four patients with systemic lupus erythematosus (SLE), one patient with dermatomyositis, and in the synovial fluid only of five patients with osteoarthritic knee effusions. Antibodies were found with each serological technique used in the synovial fluid of RA patients and the antibody titres were usually at about the same level as in the serum. The mean measles (HI, HLI, and RNP-GP) antibody titres were 4 to 6 times higher in the synovial fluid of RA patients than in synovial fluid of patients with osteoarthritic knee effusions, but a corresponding difference was not found in rubella and influenza A antibody titres. The mean measles antibody titres (CF, HI, HKI, and RNP-GP) were consistently higher in the synovial fluid of RA patients without rheumatoid factor than in the synovial fluid of RA patients with rheumatoid factor. In serum this difference was observed only with measles CF titres. The mean measles, antibody titres were consistently lower in the serum and synovial fluid of the RA patients without the synovial fluid haemolytic complement than in the RA patients with this haemolytic complement. No similar differences were found in the rubella and influenza antibody titres. No significant measles antibody titres were found in the CSF of patients with SLE or dermatomyositis.

Antibodies, Viral↗
PubMedDate not supplied

[Antigens of the synovial fluid. I. Immunodiffusion and electrophoretic studies].

9 rabbits were immunized with the synovial fluid of patients with rheumatoid arthritis. The antisera thus raised contained antibodies against 18 serum proteins and against fibrinogen. After full absorption of the antisera with human blood plasma a maximum of 5 and average of 3 typically synovial antigens could be detected in the synovial fluid by immunodiffusion. One antigen (SF1) was present in all studied human organs and connective tissue extracts. It is thermostable, insoluble in alcohol, but soluble in 0,3 N perchloric acid. The two other antigens had a lipid character, one of them was also thermostable and insoluble in alcohol and smaller amounts there-of were found in organ extracts. The antigens could also be detected in synovial effusions caused by trauma, whereas normal synovial fluid contained only two unidentified antigens in low titre. Using immunodiffusion the antisera did not show any cross reaction with synovial fluids and organ extracts of other species. Immuno-electrophoretically only the line of the SF1 in the alpha1/alpha2 area could be definitely localized.

Animals↗
PubMed1994

Single-dose pharmacokinetics of cefazolin in bovine synovial fluid after intravenous regional injection.

The pharmacokinetic properties of cefazolin in the synovial fluid of the tibiotarsal joint were determined in 10 healthy mature cattle after intravenous regional injections of 250 mg cefazolin. A pneumatic tourniquet was positioned proximal to the tibiotarsal joint and the intravenous injection was performed distal to the tourniquet. Synovial fluid concentrations of cefazolin increased in the first 30 min and fluctuated between 54.7 +/- 11.0 micrograms/ml (mean +/- SEM) and 73.2 +/- 13.2 micrograms/ml in the following 90 min while the tourniquet remained inflated. After tourniquet removal, synovial fluid concentration-time curves followed first-order one-compartment model decay in most of the animals with an elimination half-life of 0.82 h (harmonic mean). Therapeutic concentrations of cefazolin in the synovial fluid of normal joints were reached and this injection technique could be used as an alternative to systemic administration of antibiotics to provide adequate concentrations in a localized area.

Animals↗
PubMed2002

[Analysis of immunoglobulins and complement factors in synovial fluid and serum in rheumatoid arthritis, seronegative spondyloarthropathies and osteoarthritis: pathophysiology and retrospective analysis of clinical value].

UNLABELLED: Synovial fluid (SF) analysis was a mandatory investigation in rheumatological practice. In recent time, synovial fluid analysis lost importance predominantly due to unclear defined guidelines for the practical use. OBJECTIVE: To evaluate the clinical value of the determination of the complement components C'3c and C'4 and immunoglobulines IgG, IgA and IgM synovial fluid concentrations with regard to pathophysiology and currently used RA and SpA classification criteria. METHODS: Synovial fluid samples were obtained from 22 patients fulfilling ACR criteria for rheumatoid arthritis (RA), and 18 patients suffering from seronegative spondyloarthropathy (SpA) according to the ESSG criteria. Sixteen osteoarthritis (OA) SF samples were used as controls. IgG, IgA, IgM, C'3c and C'4 in SF and sera were determined by nephelometry. Comparison of the diseases, and linear as well as stepwise logistic regression analyses were performed in order to determine the interrelation of the determined parameters and a ranking of their diagnostic value for the identification of RA or SpA synovial fluids. RESULTS: SF-IgA, SF-IgG and SF-IgM concentrations were closely correlated with their corresponding serum levels (p < 0.01), while SF-C'3c and SF-C'4 depended on articular factors (p < 0.01). Determination of SF-C'3c (accuracy = 80.4%, improved chi 2 = 22.02, p < 0.001) and SF-C'4 (accuracy = 75.0%, improved chi 2 = 21.81, p < 0.001) both provided a good predictive value for the diagnosis of SpA when exceeding the cut off level of about 40 mg/dl (C'3c) or 15 mg/dl (C'4), respectively. Calculation of the C'-SF/S ratios did not provide an additional diagnostic benefit. SF-IgG, IgA and IgM as well as the calculated SF/S ratios were within the same range in RA and SpA fluids. CONCLUSIONS: SF concentration of complement components primarily depends on local articular factors. Significant differences of SF complement concentrations in established RA and SpA give reason for prospective analysis of these parameters in early undifferentiated oligoarthritis and evaluation in large studies, e.g. when re-evaluating the preliminary criteria for spondyloarthropathy.

Adult↗
PubMed1984

Synovial fluid pressure determination in the temporomandibular joint.

Synovial fluid hydrostatic pressure within the temporomandibular joint of the pig, Sus scrofa domesticus, was examined, utilizing the "wick method" for the determination of fluid pressure. Acute hydrostatic pressure levels were monitored in seven surgically exposed TMJ capsules of five animals. In six out of seven of the surgically exposed TMJ capsules, synovial fluid hydrostatic pressure was subatmospheric with the jaw in the resting position (mean = -3.8 mm of mercury). Fluid pressure increased as a response to operator-manipulated jaw position and returned to original levels upon release. In addition, an attempt was made to study fluid pressure in TMJ cavities of a functioning experimental animal model by chronically implanting a wick catheter in the joint space. Successful implantation was accomplished in two animals, and fluid pressure was monitored at 10- and 14-day intervals. Similar but slightly less negative mean "resting values" were obtained. Fluid pressures were greatly elevated during mastication.

Animals↗
PubMed1986

The effects of synovial fluid macrophages and interleukin-1 on hyaluronic acid synthesis by normal synovial fibroblasts.

The effects of peripheral blood monocyte and rheumatoid synovial fluid macrophage conditioned media were studied on hyaluronic acid (HA) metabolism of normal synovial fibroblasts. Both media stimulated HA synthesis about two-fold compared to controls (1% fetal calf serum). The activated mononuclear phagocyte conditioned media did not contain HA-degrading activity in these experiments. The effects of various concentrations of interleukin-1 (IL-1) on HA synthesis and proliferation of synovial fibroblasts were studied. Even at very low concentrations (0.1 IU IL-1/ml) HA synthesis was stimulated. With increasing concentrations HA synthesis did not increase but proliferation was stimulated. Stimulated fibroblasts synthesized mainly high molecular weight HA. Thus with IL-1-activation, normal synovial fibroblasts could not produce increased amounts of abnormal HA with decreased molecular weight.

Arthritis, Rheumatoid↗
PubMed1990

[Identification of crystals in synovial fluid].

The basic principles of the determination of crystals in synovial fluid by means of the polarisation microscope are described. The presence of crystals in synovial fluid was determined in 48 patients with the following clinical diagnoses: rheumatoid arthritis, gout, pseudogout, reactive arthritis, in patients with a diagnosis of extraarticular rheumatism: peritendinitis, in patients with reactive arthritis and in 2 patients with injured knee joint. Crystals of Na urate, Ca-pyrophosphate dihydrate and cholesterol were found. The analysis of synovial fluid for the presence of crystals in an important diagnostic procedure contributing greatly to the quick and correct diagnosis of arthritis.

Cholesterol↗
PubMed1991

The pharmacokinetics of total and unbound concentrations of tenoxicam in synovial fluid and plasma.

Tenoxicam is a nonsteroidal antiinflammatory drug with an elimination half-life of 60-80 hours; it is administered once daily. Tenoxicam concentrations were measured in plasma (10 samples) and synovial fluid (6 samples) over a 24-hour dosage interval at steady state in 10 subjects with arthritis who had been taking the drug at a dosage of 20 mg/day for at least 2 weeks. Total tenoxicam concentrations in synovial fluid were always less than those in plasma, and there was little fluctuation in plasma or synovial concentrations over the dosage interval, although there was substantial inter-subject variation in both concentrations. There was a significant relationship between the tenoxicam dosage when expressed as mg/kg of body weight and the average steady-state total concentration of tenoxicam in plasma (r = 0.80, P = 0.006); this accounted for a substantial proportion of the intersubject variation. The mean +/- SD steady-state concentrations in synovial fluid and plasma were 3.9 +/- 1.8 micrograms/ml and 9.2 +/- 3.7 micrograms/ml, respectively, yielding a mean +/- SD synovial fluid: plasma ratio of 0.43 +/- 0.12. Synovial fluid:plasma ratios of total tenoxicam correlated with synovial fluid:plasma ratios of albumin (r = 0.71, P = 0.02). The synovial fluid:plasma ratio of unbound tenoxicam was 0.90 +/- 0.3 (95% confidence interval 0.68-1.11), which was not significantly different from a value of 1 (t = -1.09, P = 0.31).

Adult↗
PubMed1990

Differences in sodium salicylate protein binding in serum and synovial fluid from patients with a knee effusion.

Protein binding of sodium salicylate in synovial fluid and in serum from 23 inpatients with rheumatic diseases were studied, ex vivo, by equilibrium dialysis. Scatchard model with two classes of sites was used as a mathematical tool. At therapeutic concentrations, protein binding of sodium salicylate was significantly higher in serum than in synovial fluid. The ratio of areas under the curves for bound concentrations for synovial fluid to that for serum was 0.867. This difference was attributed to the hypoalbuminemia observed in the synovial fluid; for a given molar ratio of drug to albumin, or in other words, for the same amount of available drug per mole of albumin. The number of sites occupied was the same in the two biological media.

Adolescent↗
PubMed1998

Interplay of matrices in cartilage synovial fluid combine under moderate & high loadings.

Interplay of the constituents of the articular cartilage synovial fluid combine and its role was examined through the biochemical and rheological studies on bovine joints. The results showed an inverse relationship between the changes in the hyaluronic acid of synovial fluid and the proteoglycans content in articular cartilage together with alterations in the rheological properties of synovial fluid. The study indicated that the inter-movement of fluid solutes across the cartilage and synovial fluid may have an important role in the pathophysiology of osteoarthritis.

Animals↗
PubMedDate not supplied

Synovial fluid and plasma concentrations of ceftiofur after regional intravenous perfusion in the horse.

OBJECTIVE: To determine radiocarpal (RC) joint synovial fluid and plasma ceftiofur concentrations after regional intravenous perfusion (RIP) and systemic intravenous (IV) administration. STUDY DESIGN: Experimental cross-over study. ANIMALS: Five normal adult horses. METHODS: One RC joint was randomly selected for RIP and the contralateral RC joint was sampled to determine intrasynovial ceftiofur concentrations after IV administration. Wash-out between IV and RIP was > or = 14 days. After surgical introduction of an intraarticular catheter, ceftiofur (2 g) was administered under general anesthesia either IV or by RIP after tourniquet application. Plasma and synovial fluid were collected over 24 hours. Samples were analyzed using high-performance liquid chromatography with ultraviolet detection and the results were statistically analyzed using a linear mixed effect model. RESULTS: Mean synovial fluid ceftiofur concentrations were consistently higher after RIP than after IV administration and were > 1 mug/mL (minimal inhibitory concentration [MIC] for common pathogens) for >24 hours. Mean synovial fluid peak concentration of ceftiofur after RIP and IV administration was 392.7+/-103.29 microg/mL at 0.5 hours postinjection (HPI) and 2.72+/-0.31 mug/mL at 1 HPI, respectively. Large variations in synovial fluid and plasma ceftiofur concentrations were observed between horses regardless of administration technique. RIP did not cause adverse effects. CONCLUSIONS: Under the present experimental conditions RIP with ceftiofur (2 g) induced significantly higher intraarticular antibiotic concentrations in the RC joint in comparison with IV administration. Moreover, after RIP, synovial fluid ceftiofur concentrations remain above the MIC for common pathogens (1 microg/mL) for > 24 hours. No adverse effects from the technique or the antibiotic were observed. CLINICAL RELEVANCE: RIP with high doses of ceftiofur may be a beneficial adjunctive therapy when treating equine synovial infections which are caused by cephalosporin susceptible microorganisms.

Animals↗
PubMed1993

Clinical and laboratory parameters which affect soluble interleukin-2 receptor levels in the serum and synovial fluids of patients with rheumatoid arthritis.

OBJECTIVE: To investigate whether soluble interleukin-2 receptor (sIL-2R) could be a useful marker of disease activity in rheumatoid arthritis (RA); sIL-2R levels in serum and in synovial fluid were determined by enzyme-linked immunosorbent assay. METHODS: Sixty five serum and 27 synovial fluid samples were obtained from patients with RA. Twenty five serum and 28 synovial fluid samples from patients with osteoarthritis (OA) were used as controls. Furthermore, 10 synovial fluid samples from healthy volunteers were also examined. Variable laboratory and clinical data were compared with serum sIL-2R levels, in 26 patients with RA and serial samples from some patients were examined. RESULTS: Concentrations of sIL-2R in serum (median 81, range 40-350 pM) and synovial fluid (median 125, range 52-460 pM) from patients with RA were significantly higher than in serum (median 45, range 13-100 pM) and synovial fluid (median 37, range 15-140 pM) from patients with OA, and healthy control synovial fluid (median 2.5, range 0-10 pM). Serum sIL-2R levels correlated strongly with serum levels of C-reactive protein (p = 0.0001), and a significant correlation with erythrocyte sedimentation rate (ESR) (p = 0.048), IgG levels (p = 0.028), IgA levels (p = 0.044) and Lansbury Index (p = 0.037) was observed. However, serum sIL-2R levels showed no significant correlation with rheumatic factor, IgM or T cell subsets. CONCLUSION: These findings indicate that sIL-2R levels in patients with RA reflect disease activity.

Arthritis, Rheumatoid↗
PubMed1990

Purification and characterization of a phospholipase A2 from human osteoarthritic synovial fluid.

Phospholipase A2 (PLA2) from human osteoarthritic synovial fluid was purified to homogeneity in three steps. The NH2-terminal amino acid sequence and biochemical characteristics of the enzyme were identical to the Peak A PLA2 activity of rheumatoid synovial fluid (1). The enzyme exhibited an apparent mass of 14,000, an absolute Ca+(+)-dependence, an alkaline pH optimum, and was inhibited by sodium deoxycholate (DOC), NaCl and 0.5 M Tris-HCl. The enzyme strongly preferred phosphatidylethanolamine (PE) as substrate over phosphatidylcholine (PC) or phosphatidylinositol (PI), and hydrolyzed PE containing arachidonic acid or linoleic acid in the sn-2 position at similar rates. Heparin bound to the enzyme but did not inhibit catalytic activity. In addition, the human enzyme was not inhibited by the acidic 'chaperone' subunit of crotoxin despite considerable sequence similarity with the basic PLA2 subunit of the neurotoxin. The enzyme was capable of hydrolyzing E. coli membrane phospholipids in the presence of the neutrophil bactericidal/permeability increasing protein (BPI). This finding, coupled to the reported pro-inflammatory activity and presence of the enzyme in inflammatory cells, supports the hypothesis that it may be a component of the host defense mechanism which can, under certain conditions, contribute to the pathogenesis of inflammatory disease.

Amino Acid Sequence↗
PubMed1995

Assessment of glycosaminoglycan concentration in equine synovial fluid as a marker of joint disease.

A modification of a colorimetric assay was used to determine synovial fluid total and individual sulphated-glycosaminoglycan concentration in various clinical presentations of joint disease in horses. Concentrations of synovial fluid and serum sulphated-glycosaminoglycan (GAG) were measured by the 1,9-dimethylmethylene blue (DMMB) dye assay in normal horses (n = 49), horses with acute (n = 26) or chronic (n = 27) joint disease (defined by clinical, radiographic, and clinicopathological parameters), and horses with cartilaginous lesions at diagnostic arthroscopy, but with normal radiographs and synovial fluid (n = 9). Horses with acute joint disease were subdivided into moderate acute (n = 21) and severe acute (n = 5) joint disease on the basis of synovial fluid analysis and clinical examination. Horses with chronic joint disease were subdivided into mild chronic (n = 9), moderate chronic (n = 10), and severe chronic (n = 8) joint disease on the basis of synovial fluid analysis, clinical examination, and radiographic findings. The concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) were analyzed in each sample following sequential enzymatic digestion of the sample with chondroitinase or keratanase. In addition, the concentration of hyaluronate (HA) in each sample was determined by a colorimetric assay following digestion of the sample with microbial hyaluronidase.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1985

Blastomycosis presenting as monoarticular arthritis. The role of synovial fluid cytology.

Joint complaints are common among patients with blastomycosis; however, true arthritis is infrequently documented by synovial fluid analysis. Of 72 individuals with blastomycosis who were patients at the Vanderbilt School of Medicine affiliated hospitals during the period 1957-1983, 6 (8%) had arthritis at presentation. In 5 patients (7%), monoarticular arthritis was the chief complaint leading to hospitalization. Cytologic examination of synovial fluid was performed in 4 patients and demonstrated characteristic organisms each time. Three patients had negative 10% potassium hydroxide smears, and 2 had negative synovial fluid cultures. Blastomycosis should be considered in the differential diagnosis of acute arthritis. In patients with blastomycotic arthritis, cytologic examination of synovial fluid can add to the diagnostic yield of synovial fluid fungal cultures and potassium hydroxide preparations.

Adolescent↗
PubMed1988

Human arthritic synovial fluid influences proteoglycan biosynthesis and degradation in organ culture of bovine nasal cartilage.

The influence of synovial fluid and serum from patients with inflammatory joint disease on proteoglycan metabolism was studied in organ culture of bovine nasal cartilage. Proteoglycan biosynthesis, i.e. incorporation of [35S]-sulphate, was reduced after addition of synovial fluid from rheumatoid arthritis and reactive arthritis patients. Also some rheumatoid arthritis sera but no reactive arthritis serum reduced the biosynthesis compared to control sera. Proteoglycan degradation, i.e. release of proteoglycans prelabelled with [35S]-sulphate, as well as release of proteoglycans determined by chemical methods, was highest under the influence of rheumatoid arthritis synovial fluid. This effect appears to represent an activity truly stimulating degradation, since added control serum did not prevent the effect. The lowest proteoglycan degradation was observed in culture medium only. Addition of synovial fluid compared to addition of control serum did not increase proteoglycan degradation in freeze-killed cartilage indicating that the effect requires living cells. The findings are consistent with the presence in synovial fluid of mediators stimulating the chondrocytes both to activate proteoglycan degradation and to reduce proteoglycan biosynthesis.

Animals↗
PubMed1992

Plasminogen activators in synovial fluid and plasma from patients with arthritis.

The activity of plasminogen activators and inhibitors in the synovial fluid and plasma of patients with various forms of chronic arthritis was characterised. Tissue-type plasminogen activator antigen (t-PA:Ag), urokinase-type plasminogen activator antigen (u-PA:Ag), the proenzyme single chain u-PA (scu-PA), and plasminogen activator inhibitor (PAI) were measured in the synovial fluid and plasma of 22 patients with seropositive rheumatoid arthritis (RA), 13 with seronegative RA, and 23 patients with various forms of arthritis. In all patient groups the levels of t-PA:Ag in synovial fluid were lower and the levels of u-PA:Ag and PAI higher than plasma levels. Synovial fluid u-PA was more activated than plasma u-PA. Comparison of the patient groups showed that the largest differences between fibrinolytic parameters in synovial fluid and plasma were present in patients with seropositive RA followed by patients with seronegative RA and patients with various forms of arthritis. This order paralleled the functional and radiological scores of joint destruction in the patient groups studied. The results of this study indicate that suppression of t-PA production and enhancement of u-PA synthesis and activation in arthritic joints are associated with the clinical severity of arthritis.

Arthritis↗
PubMed1989

Fragmented fibronectin and other synovial fluid proteins in chronic arthritis: their relation to immune complexes.

Fibronectin, an opsonic glycoprotein has been shown to exist in fragmented forms in serum and synovial fluid. Some fragments in synovial fluid appear to be polyethylene glycol (PEG) precipitable, suggesting incorporation into immune complexes (IC). PEG precipitation, SDS-PAGE and immunoblotting were used to determine whether PEG precipitable fragments are real or artefactual. Disease specificity of fragmentation and IC incorporation of fibronectin and other proteins were also studied using these techniques. PEG precipitable fragments do not appear to be artefactual, although some fibronectin fragments are cryoprecipitable. Protein fragments showed similar distributions in whole serum and synovial fluid, disease specific differences being confined to PEG precipitates. Rheumatoid arthritis (RA) synovial fluid PEG precipitates displayed the greatest array of fragmented immunoglobulins and fibronectin. No PEG precipitates contained albumin fragments. Protein fragments in IC may impair their effective removal from RA joints. Accumulated IC could lead to tissue damage via complement activation.

Adult↗