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PubMedDate not supplied

Complement determinations in the synovial fluid and serum of a patient with Erythema nodosum leprosum.

Simultaneous serum and synovial fluid CH50, C1, C4, C2, C1 esterase inhibitor and C3 protein were determined in a patient with acute erythema nodosum leprosum. The pattern of synovial fluid complement activity coupled with the demonstration of multiple lepra bacilli free and within histiocytes is more consistent with an infectious than an immune complex induced synovitis.

Arthritis, Infectious↗
PubMed1985

Normal human synovial fluid: osmolality and exercise-induced changes.

We measured the osmolality of human synovial fluid in the knees of healthy young adults following minimum activity and exercise. These results were compared with each subject's blood-serum osmolality. The synovial fluid was hyperosmolal with minimum activity, decreasing to blood-serum levels after exercise.

Adult↗
PubMed1994

[Value of cytological analysis of the synovial fluid in multicentric reticulohistiocytosis. A case].

The authors report the case of a patient who had both multicentric reticulohistiocytosis--a systemic disease characterized by symmetric polyarthritis and papulonodular skin lesions--and an ovarian adenocarcinoma. Synovial fluid analysis found histiocytes with a ground-glass cytoplasm, binucleate giant cells, and undifferentiated cells undergoing mitosis. PAS-positive, diastase-resistant cells similar to the synovial fluid histiocytes were seen in the synovial and cutaneous biopsy specimens. These findings established the diagnosis of multicentric reticulohistiocytosis and suggested an underlying malignancy. Whether or not multicentric reticulohistiocytosis is a paraneoplastic syndrome remains unsettled. However, our report provides evidence that synovial fluid analysis can be helpful not only for the early diagnosis of multicentric reticulohistiocytosis but also for suggesting the presence of an underlying tumor, especially when arthritis is the presenting symptom.

Adenocarcinoma↗
PubMed1992

Synovial fluid leukocytosis in bacterial arthritis vs. reactive arthritis and rheumatoid arthritis in the adult knee.

In this comparative analysis of laboratory data, we examined the characteristics of synovial fluid leukocytosis in eighty adult patients with bacterial arthritis, reactive arthritis or rheumatoid arthritis of the knee joint. Synovial fluid leukocyte count and the percentage of polymorphonuclear cells seemed to perform well as a discriminator between bacterial infection and acute flare of the underlying disease in patients with rheumatoid arthritis. In contrast, there were no definite difference in the intensity of synovial fluid leukocytosis between patients with bacterial arthritis caused by living bacteria and patients with reactive arthritis probably caused by bacterial antigens.

Adolescent↗
PubMed1996

Elevated levels of corticotrophin-releasing factor binding protein in the blood of patients suffering from arthritis and septicaemia and the presence of novel ligands in synovial fluid.

In view of the reported inflammatory effects of corticotrophin-releasing factor (CRF) and the associated regulatory elements in the gene of its binding protein (BP), we postulate that both BP as well as novel BP-ligands other than CRF may be involved in inflammatory disease. We have investigated BP in the blood of patients with arthritis and septicaemia and have attempted to identify CRF and other BP-ligands in synovial fluid. The BP was found to be significantly elevated in the blood of patients with rheumatoid arthritis and septicaemia. There was less BP-ligand and CRF in synovial fluid from patients with rheumatoid arthritis that from those with osteo- or psoriatic arthritis. There was at least 10-fold more BP-ligand than CRF in the fluid of all three groups of patients. A small amount of immunoreactive human (h)CRF, eluting in the expected position of CRF-41, was detected after high-pressure liquid chromatography of arthritic synovial fluid; however, the bulk of material with BP-ligand binding activity eluted earlier, suggesting that synovial fluid contained novel peptides that interacted with the BP. These results would suggest that the BP and its ligands could play an endocrine immunomodulatory role in inflammatory disease.

Acute Disease↗
PubMed1983

Studies of rheumatoid synovial fluid lymphocytes. II. A comparison of their behavior with blood mononuclear cells in the autologous mixed lymphocyte reaction and response to TCGF.

Synovial fluid lymphocytes (SFL) and peripheral blood lymphocytes (PBL) from patients with rheumatoid arthritis were compared for their response to lectin stimulation and for their behavior in the autologous mixed lymphocyte reaction (AMLR). The SFL proliferative response to phytohemagglutinin (PHA), as measured by tritiated thymidine incorporation at 72 hr, was lower than that of PBL (P less than 0.001). When T-cell growth factor (TCGF) was added to the medium, there was an increase in the SFL proliferative response to PHA (P less than 0.05). In contrast, TCGF did not alter significantly the PBL proliferative response to PHA. Mixing experiments were performed to determine whether the poor SFL proliferative response was due to passive absorption and removal of in situ-generated TCGF by "suppressor" cells. When cultured together, SFL did not suppress the PBL proliferative response to PHA, suggesting that decreased production of TCGF rather than competitive binding of TCGF results in the poor SFL proliferative response to lectin stimulation. In the AMLR, synovial fluid non-T cells were found to be more stimulatory to peripheral blood T cells than were peripheral blood non-T cells (P less than 0.001). In comparison to peripheral blood T cells, synovial fluid T cells were poor responders in the AMLR. Repetitive in vitro autologous stimulation of peripheral blood T cells resulted in proliferative responsiveness analogous to that of SFL, i.e., a relatively poor proliferative response in the AMLR and a poor response to PHA. The latter could be augmented by TCGF. The SFL requirement for exogenous TCGF is consistent with a state of immune activation. In vivo stimulation by non-T cells may play an important role in the immune activation which characterizes rheumatoid SFL.

Adult↗
PubMed1989

Comparison of serum and synovial fluid concentrations of beta 2-microglobulin and C reactive protein in relation to clinical disease activity and synovial inflammation in rheumatoid arthritis.

beta 2-Microglobulin and C reactive protein (CPR) were measured in 33 and 57 matched pairs of serum and synovial fluid (SF) respectively, from patients with active rheumatoid arthritis (RA). Serum beta 2-microglobulin concentrations were higher than in normal controls and the SF concentration was higher than the serum concentration on 25 of 33 occasions (76%), suggesting a local production of beta 2-microglobulin within the synovial membrane. There was a correlation between serum and SF concentrations of beta 2-microglobulin (r = 0.50). Patients' serum CRP concentrations in 57 samples were higher than in normal controls and were greater than in the matched SFs on 49 of the 57 paired samples (86%). In 18 samples CRP was absent in the SF, suggesting a local consumption or binding within the synovial membrane. Twenty four patients with RA given either sodium aurothiomalate or D-penicillamine for six months showed highly significant clinical improvements accompanied by reductions in serum and SF immunoglobulin concentrations and knee joint suprapatellar pouch synovial membrane T lymphocyte infiltrates. In this group of patients serum CRP, but not beta 2-microglobulin, fell significantly, but there were no significant changes in SF beta 2-microglobulin or CRP. These data suggest that serum and SF beta 2-microglobulin concentrations are not a useful index for determining the therapeutic response to sodium aurothiomalate and D-penicillamine and that serum rather than SF CRP concentrations are more helpful. The persistent raised serum and SF concentrations of beta 2-microglobulin probably reflect synovial inflammatory infiltrates, which are still considerable despite apparent clinical remission.

Arthritis, Rheumatoid↗
PubMed1983

The synovium and synovial fluid in multicentric reticulohistiocytosis--a light microscopic, electron microscopic and cytochemical analysis of one case.

The synovium and synovial fluid have been studied in a patient with multicentric reticulohistiocytosis. Previously unreported histochemical, immunocytochemical and ultrahistochemical findings are presented and their relevance to the aetiology and pathogenesis are discussed. The synovial fluid analysis in this disease is characteristic and may be helpful in its early diagnosis.

Acid Phosphatase↗
PubMed1991

Synovial fluid 5'-nucleotidase activity. Relationship to other purine catabolic enzymes and to arthropathies associated with calcium crystal deposition.

We measured 5'-nucleotidase (5NT) activity in synovial fluid from 159 patients with various diagnoses. The activity of 5NT was compared with activities of nucleotide pyrophosphohydrolase, alkaline and neutral phosphatases, and adenosine deaminase, in the same samples. Higher levels of 5NT activity occurred in synovial fluid from osteoarthritic joints than from joints of patients with gout, pseudogout, or rheumatoid arthritis. The highest levels of 5NT activity were found in synovial fluid from patients with Milwaukee shoulder syndrome and from osteoarthritis patients in whom deposition of calcium-containing crystals was also present.

5'-Nucleotidase↗
PubMed1976

[Synovial fluid. Review of international literature from 1972 to 1975 (author's transl)].

The tremendous increase in the number of articles from the world scientific literature dealing with the synovial fluid in recent years, reflects the growing interest of research on that subject. The current review summarizes the scientific works published during the period of 1972 to 1975. This review deals with fundamental as well as applied research or clinical reports adding some diagnostic hints in the knowledge of diseases involving joints. The content of the review is divided in two major chapters. 1) The Physico-Chemical Properties of the Synovial Fluid (viscosity, pH,...); 2) The Composition of the Synovial Fluid (proteins, carbohydrates, lipids, prostaglandins, cells, crystals, micro-organisms).

Antibodies, Antinuclear↗
PubMed1992

Inhibition of synovial fluid T cell proliferation by anti-CD5 monoclonal antibodies. A potential mechanism for their immunotherapeutic action in vivo.

OBJECTIVE: Monoclonal antibodies (MAb) directed against the T cell surface molecule CD5 are able to provide accessory stimulatory signals to resting T cells. The potential role of CD5 as an immunoregulatory molecule in inflammatory synovitis was examined. METHODS: Synovial fluid and peripheral blood T cells of patients with active rheumatoid arthritis (RA) were purified and stimulated with interleukin-2 (IL-2), and the effect of MAb directed against CD5 on IL-2 responsiveness was examined. RESULTS: IL-2-induced proliferation of synovial fluid T cells was strongly inhibited by anti-CD5 MAb, but not by anti-CD28 or anti-CD3 MAb. In RA peripheral blood T cells, MAb directed against CD5, CD3, and CD28 induced IL-2-dependent T cell growth, similar to findings in healthy controls. The difference in activity of anti-CD5 MAb on synovial fluid T cells compared with peripheral blood T cells was not due to different surface expression of CD5. CONCLUSION: Anti-CD5 has an inhibitory effect on in vivo-activated synovial fluid T cells. The disease-ameliorative effects of anti-CD5 immunotoxin treatment of RA may be partly due to "switching-off" of T cell activation in the joints.

Adult↗
PubMed1991

Analysis of function-associated receptor molecules on peripheral blood and synovial fluid granulocytes from patients with rheumatoid and reactive arthritis.

In this study we report the expression pattern of 13 different function-associated surface molecules on synovial fluid and peripheral blood granulocytes from rheumatoid and reactive arthritis patients. We found increased expression of the complement receptors 1 (CD35) and 3 (CD11b) and of the activation-associated antigens CD67, CD24, and M5 on synovial fluid granulocytes from rheumatoid and/or reactive arthritis patients compared to autologous peripheral blood granulocytes. In addition, synovial fluid granulocytes expressed IgG Fc receptor 1 (CD64) and complement receptor 4 (CD11c), neither of which can be found on peripheral blood granulocytes. Peripheral blood granulocytes from rheumatoid and reactive arthritis patients expressed higher levels of leucocyte function-associated antigen 1 (CD11a) and of the membrane proteins CD31, CD24, M5, and M6 compared to peripheral blood granulocytes from healthy controls and patients with degenerative joint disease. No significant differences in the expression of any of the molecules studied could be observed between cells from rheumatoid and cells from reactive arthritis patients, suggesting a similar activation process for granulocytes in these two diseases.

Antigens, CD↗
PubMed1999

V2 regions of 16S ribosomal RNA used as a molecular marker for the species identification of streptococci in peripheral blood and synovial fluid from patients with psoriatic arthritis.

OBJECTIVE: To detect the 16S ribosomal RNA (rRNA) of 3 streptococcal species in the peripheral blood and synovial fluid of patients with psoriatic arthritis (PsA). METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) detection targets bacterial 16S rRNA, which is present in bacteria at high copy numbers. The 3 species-specific primers for group A streptococci (GAS; Streptococcus pyogenes), group B streptococci (GBS; Streptococcus agalactiae), and Streptococcus pneumoniae were designed from the fragments of highly variable V2 regions of 16S rRNA. Total RNA was prepared from whole peripheral blood and joint fluid obtained from patients with PsA and rheumatoid arthritis (RA). All positive PCR reactions were then sequenced with a Pharmacia ALF DNA sequencing system. RESULTS: Our data in 19 PsA patients showed that 7 peripheral blood samples were positive for GAS (P = 0.006 versus GAS-positive RA patients [n = 0], by Fisher's exact test), and 2 were also positive for GBS. One synovial fluid sample from a PsA patient was positive for GAS. S pneumoniae was absent from all specimens. Seventeen patients with RA were PCR negative for the 3 streptococcal species. Peripheral blood from a patient with inflammatory bowel disease was positive for GAS. CONCLUSION: The presence of GAS 16S rRNA in the peripheral blood and synovial fluid of patients with PsA supports the concept that PsA is a reactive arthritis to certain streptococci.

Arthritis, Psoriatic↗
PubMed2005

Effects of different hyaluronic acid products on synovial fluid NO levels in knee osteoarthritis.

The aim of the present study was to evaluate the effects of different hyaluronic acid forms on synovial fluid nitric oxide (NO) levels and glutathione peroxidase (GSHPx) activities in the treatment of patients with knee osteoarthritis (OA). Forty patients were equally randomized into two groups and treated with native sodium hyaluronate (group I) or with cross-linked hylan G-F 20 (group II). Clinical evaluations and synovial fluid aspirations were performed before the first (baseline), the second (week 1), and third injections (week 2), and a week after the third injection (week 3). NO levels were reduced at the end of the study in both groups (p<0.01 in group I, p=0.001 in group II), while no significant change was found in GSHPx activity. Also, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores and WOMAC physical function scores were gradually improved at all follow-ups in the two groups. No significant differences between the two groups of NO levels, GSHPx activity, WOMAC pain scores, WOMAC stiffness scores, and WOMAC physical function scores were recorded during the study. Intra-articular hyaluronic acid therapy may reduce synovial fluid NO levels. These effects do not seem to be dependent on the molecular weight and various structural changes of hyaluronan products.

Aged↗
PubMed2001

Increased concentrations of protein gene product 9.5 in the synovial fluid from horses with osteoarthritis.

Our previous study established protein gene product 9.5 (PGP 9.5), a ubiquitin C-terminal hydrolase, as a specific cytochemical marker of synovial lining cells (type B synoviocytes) in the horse joint. The present study aimed to detect PGP 9.5 in the synovial fluid and shows that PGP 9.5 is a valuable marker of osteoarthritis in the horse. Immunohistochemical staining confirmed rich and consistent localization of PGP 9.5 immunoreactivity in the cytoplasm of synovial lining cells in the normal horse joint. Western blot analysis of synovial fluid from normal joints could detect a significant band corresponding to that contained in the brain and synovial membrane extracts. When 60 synovial fluid samples from normal and abnormal joints were assayed with an enzyme-linked immunosorbent assay (ELISA) system, the concentration of PGP 9.5 tended to be elevated in osteochondrosis dissecance, inflammatory arthropathy and intra-articular fracture, among which a statistically significant elevation was recognizable between the intra-articular fracture and the control. Thus, this study demonstrated the possibility that PGP 9.5, derived from synovial lining cells, may be a new biochemical marker for arthritic disorders of the horse.

Animals↗
PubMed1994

Synovial fluid and plasma levels of cartilage matrix glycoprotein in arthritis.

As cartilage matrix glycoprotein (CMGP) is a prominent matrix constituent, we analyzed the relationship of levels in plasma (CMGPP) and synovial fluid (CMGPS) to each other, to clinical diagnosis, and to degree of radiographic cartilage degeneration. CMGP was measured in matched synovial fluid and plasma specimens from 67 patients with various forms of arthritis using an ELISA technique. CMGPS consistently exceeded CMGPP, CMGPP levels correlated significantly with CMGPS levels, and CMGP retention in joint fluid, as calculated by the ratio CMGPS: CMGPP, was significantly higher in patients whose synovial fluids contain basic calcium phosphate crystals. No correlation of CMGPP or CMGPS with diagnosis or degree of cartilage degeneration was observed. CMGP measurements are not useful diagnostically in patients with chronic arthritis and do not predict degree of radiographic degeneration. The association of basic calcium phosphate crystals with intraarticular retention of CMGP warrants further study.

Arthritis, Rheumatoid↗
PubMed1998

Plasma and synovial fluid soluble CD23 concentrations in children with juvenile chronic arthritis.

Since increased levels of sCD23 were demonstrated in patients with autoimmune diseases, plasma and synovial fluid sCD23 levels were examined in 22 patients with juvenile chronic arthritis (JCA) and in 10 children undergoing arthrocentesis for orthopedic disorders. There was no significant difference in plasma sCD23 concentrations between patients with pauciarticular and polyarticular onset. Plasma and synovial fluid sCD23 concentrations were found to be significantly increased in JCA patients as compared to controls. However, plasma sCD23 levels were not positively correlated with laboratory parameters showing disease activity such as erythrocyte sedimentation rate, C-reactive protein, serum IgG and IgA. It was concluded that increased production of sCD23 in peripheral blood and synovial fluid might be important in the pathogenesis of JCA. However, determination of this immunological parameter provides no useful clinical information about disease activity and management.

Adolescent↗