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PubMed1990

A rapid and highly sensitive method for the quantitative determination of dexamethasone in plasma, synovial fluid and tissues by combined gas chromatography/negative ion chemical ionization mass spectrometry.

A new, simple and highly sensitive assay is developed for the quantitative measurement of very low levels of dexamethasone in human plasma, synovial fluid and tissues following a topical administration of the drug. Dexamethasone and the internal standard, flumethasone, are measured by gas chromatography/negative ion chemical ionization mass spectrometry with methane as the reagent gas. After a three-step extraction procedure, the two compounds of interest are converted to their trimethylsilyl ether derivatives using trimethylsilylimidazole and formamide as the base catalyst. Under soft derivatization conditions only one chromatographic peak corresponding to the trisubstituted derivative is observed. The mass spectrometer is focused to monitor abundant and stable characteristic high-mass ions (m/z 446 and 464) which are generated in the ion source by an electron capture process. This assay requires only 1 ml of plasma or 0.5 ml of synovial fluid and the detection limit of the method is equal to 0.1 ng ml-1 with a relative standard deviation lower than 6%.

Adipose Tissue↗
PubMed1995

Application of markers of collagen metabolism in serum and synovial fluid for assessment of disease process in patients with rheumatoid arthritis.

OBJECTIVE: To assess the potential of markers of collagen metabolism to reflect disease processes in rheumatoid arthritis (RA). METHODS: Serum (S) and synovial fluid (SF) from 59 patients with RA, and a knee joint effusion and serum from 90 control subjects were studied with radioimmunoassays for the aminoterminal propeptides of type I and type III procollagens (PINP and PIIINP, respectively). The breakdown of type I collagen was quantified with a radioimmunoassay for the cross linked carboxyterminal telopeptide of type I collagen (ICTP). RESULTS: About 50% of the patients had increased S-ICTP and S-PIIINP values, whereas S-PINP was increased in only 20% of the patients. The mean SF:S ratios of these markers varied between 4 (for ICTP) and 340 (for PIIINP), indicating that markers of collagen metabolism are formed locally and then released into the circulation. SF-PINP and SF-PIIINP correlated with each other (rs = 0.86, p < 0.001) and with SF-ICTP (rs = 0.69, p < 0.001, and rs = 0.65, p < 0.001, respectively). SF-ICTP was clearly related to radiographic findings in the corresponding knee joint, patients with gross bone deformation having the greatest SF-ICTP concentrations. S-ICTP and S-PIIINP also correlated with conventional markers of disease activity, such as C reactive protein and joint swelling score. CONCLUSION: Markers of collagen metabolism both in serum and synovial fluid can be measured to provide an assessment of disease process in patients with RA. ICTP and PIIINP are the most informative.

Adult↗
PubMed1992

Characterization of a bovine synovial fluid lubricating factor. II. Comparison with purified ocular and salivary mucin.

Boundary lubricating activity and biochemical characteristics of purified lubricating factor from bovine synovial fluid (PSLF) were compared to those of mucinous glycoprotein from human submandibular saliva and stimulated tears. Mammalian synovial fluid and saliva contain mucinous glycoproteins which reduce the coefficient of friction (mu) in a bearing of latex:glass which isolates boundary lubrication. In contrast, mucin secreted by the lacrimal gland did not lubricate. Cleveland plotting showed that these species are not identical.

Animals↗
PubMed1992

Supravital staining of synovial fluid with Testsimplets.

We explored the use of Testsimplet (TS) in synovial fluid (SF) analysis. TS is a glass slide coated with a dry mixture of methylene blue and cresyl violet, which in contact with one drop of SF provides a stained fresh preparation. We applied the TS to the study of 159 SFs of patients with different rheumatic diseases. In those SFs of patients with crystal-associated diseases, the crystal search was performed both on unstained preparations and with TS. TS was as good as the Wright's and Papanicolaou stain in characterizing SF cells, lupus erythematosus cells, and detection of occasional bacteria. TS allowed a better visualization of Reiter's cells, cartilage fragments, synovial villi, fat droplets, and fibrin. Crystals were identified in every TS of those patients with crystal-associated diseases. TS is a rapid and reproducible method of SF supravital staining. Crystals are well preserved for simultaneous examination with compensated polarized light.

Benzoxazines↗
PubMed1980

Migration of blood and synovial fluid neutrophils obtained from patients with rheumatoid arthritis.

The unstimulated random migration and the serum-induced chemokinesis of neutrophils obtained from the peripheral blood of patients with rheumatoid arthritis (n = 19) was not different from those of controls (n = 20). However, neutrophils obtained from the joint fluid of rheumatoid patients (n = 10) demonstrated a reduced serum-induced chemokinesis which was correlated with the amount of immune complexes present in the synovial fluid. The chemotactic response of peripheral blood neutrophils from subjects with rheumatoid arthritis taking aspirin (n =11) was increased while that of those rheumatoid subjects not taking aspirin (n = 8) was the same as controls. It is concluded that although there is no impairment of the in vitro migratory capacities of peripheral blood neutrophils obtained from patients with rheumatoid arthritis, neutrophils obtained from synovial fluids exhibit a marked defect in chemokinesis which may be related to the ingestion of immune complexes within the joint space.

Aged↗
PubMed2002

Correlation of bone and cartilage markers in the synovial fluid with the degree of osteoarthritis.

In recent years, many biochemical markers were tested with the aim of developing a tool for the early detection and monitoring of osteoarthritis (OA). Apart from chondral markers, we also evaluated osseous markers from the synovial fluid to obtain more comprehensive information, and we compared the levels in relation to the severity of OA. In this prospective, cross-sectional study, synovial fluid samples were obtained from 73 patients with OA of the knee joint prior to operation and after the joint was flushed with 50 ml of normal saline. All patients underwent surgery and were classified in accordance with the Outerbridge and the Noyes classification. The measured biochemical markers included pyridinoline (PD), deoxypyridinoline (DPD), N-telopeptide (NTx), carboxyterminal propeptide of collagen-1 (PICP), matrix metalloproteinases (MMP-1 and MMP-3), and tissue inhibitor of MMPs (TIMP-1). The marker levels were normalized against the total protein content and were compared with the Outerbridge and the Noyes classification. For the majority of markers, the correlation coefficient was below r=0.3, with large 95% confidence intervals. The highest correlation coefficients were obtained from DPD and TIMP-1. In relation to the Outerbridge classification, DPD revealed high values only in stage IV. The overall results indicate that the majority of the tested markers are unspecific with regard to the different stages of OA. The two markers with the highest correlation coefficients showed no major sensitivity to detect OA at an initial stage. However, they might give additional information to clinical and radiological findings with regard to the severity of the disease.

Amino Acids↗
PubMed1992

Characterization of type V collagenase (gelatinase) in synovial fluid of patients with inflammatory arthritis.

Gelatin degrading matrix metalloproteinases in synovial fluid from 21 patients with inflammatory arthritis were shown to consist of two distinct gene products, 92 and 70 kDa gelatinases. The gelatinolytic activity of 92 kDa enzyme, which is released from stimulated neutrophils, was positively correlated to neutrophil count in the fluid. By contrast, 70 kDa molecule did not correlate with neutrophil cell count. Purification of these enzymes revealed they could degrade type XI collagen, a cartilage component resistant to interstitial collagenase. The elevated levels of 92 kDa gelatinase in rheumatoid arthritis samples compared to osteoarthritis suggest a role of this enzyme in cartilage destruction.

Adult↗
PubMed1965

The physiopathological changes in synovial fluid in arthritic swine.

There was produced with Ery. rhusiopathiae a rheumatoid-like arthritis in swine, which passed successively through acute, sub-acute and chronic stages. This was typically a non-suppurative proliferative change with concurrent changes in the joint fluid. The arthritis was shown to persist even though the initial inciting agent could not be isolated from the advanced cases of chronic polyarthritis. This strongly suggests that the pathological process responsible for this arthritis can become autonomic and probably is related to a state of hypersensitivity. The cellular changes observed in the synovial fluid did not differ markedly from those of rheumatoid arthritis in man. Synovial fluid mucinous changes were apparent in the decreased viscosity observed grossly. Definite changes in the character of the precipitate produced by acetic acid treatment of the fluid were also observed.

Animals↗
PubMed1982

Cefoxitin antibiotic concentration in bone and synovial fluid.

A single intravenous 2 g dose of cefoxitin, a broad spectrum antibiotic, was administered prophylactically just prior to operation on 60 patients undergoing total joint replacement (30 total hip replacements, 30 total knee replacements). Specimens of blood, bone, and synovial fluid were obtained during the operative procedure and assayed for cefoxitin concentration. Peak serum levels drawn five minutes after completion of antibiotic administration showed an average of 191 mcg/ml. Synovial fluid specimens were obtained an average of 33 minutes following antibiotic administration with a mean cefoxitin concentration of 72 mcg/ml. Bone samples from either the femoral condyle or femur head were taken an average of 65 minutes after the antibiotic was given and showed a mean cefoxitin concentration of 12 mcg/g. Simultaneous serum concentration was 63 mcg/ml. No allergic reactions occurred despite a history of skin rash after penicillin in eight patients. One patient developed deep infection caused by poor healing of the skin over the surgical site, thus leading to infection and involvement of the joint well after prophylaxis ended.

Biological Assay↗
PubMed1991

Human cartilage is degraded by rheumatoid arthritis synovial fluid but not by recombinant cytokines in vitro.

Rheumatoid arthritis (RA) synovial fluid (SF) stimulated significant loss of glycosaminoglycans (GAG) from normal and pathological human cartilage biopsies over 2 days as compared with normal human serum. By contrast, 15 RA SFs failed to degrade killed normal cartilage, and degraded killed RA cartilage less effectively than living RA cartilage. Four RA SFs were treated with neutralizing anti-cytokine antisera prior to incubation with normal cartilage. The degrading effects of two of the fluids were reversed by anti-interleukin-1 alpha (IL-1 alpha) while degradation by the third and fourth fluids were reversed by anti-interleukin-1 beta (IL-1 beta) and anti-tumour necrosis factor-alpha (TNF-alpha), respectively. However, recombinant human IL-1 alpha, IL-1 beta, TNF alpha or a combination of all three cytokines had no degrading effect in this 2-day culture system. It is concluded that RA SF degrades cartilage by a mechanism involving a synergistic interaction between cytokines and some other component of SF.

Arthritis, Rheumatoid↗
PubMed1994

Direct degradation of articular cartilage by rheumatoid synovial fluid: contribution of proteolytic enzymes.

OBJECTIVE: To test the effects of synovial fluids (SF) on human cartilage in an in vitro model. METHODS: Freshly collected SF were incubated with cryostat sections of articular cartilage, and glycosaminoglycan (GAG) loss determined by microdensitometry after alcian blue staining. RESULTS: Of 20 rheumatoid SF, 11 induced significant GAG loss compared with only 3 out of 15 osteoarthritic SF. The effect of rheumatoid fluids appeared to be related to disease activity. GAG loss was partially prevented by a broad spectrum serine protease inhibitor and a specific elastase inhibitor. Cartilage degrading activity was lost on storage which may explain why it has not been widely reported before. CONCLUSION: Rheumatoid SF can directly degrade cartilage through the action of proteases. There is an involvement of serine proteases, elastase in particular.

Adult↗
PubMedDate not supplied

A remarkable increase of superoxide dismutase activity in synovial fluid of patients with rheumatoid arthritis.

Superoxide dismutase activities in the synovial fluid of patients with rheumatoid arthritis and osteoarthritis were determined by the technique of McCord and Fridovich. The superoxide dismutase activity from the rheumatoid arthritis group was found to be remarkably higher than that from the osteoarthritis group. The high superoxide dismutase activity of rheumatoid arthritis is correlated with the severity of the disease. A significant correlation was also found between C-reactive protein and superoxide dismutase activity. These observations suggest that superoxide dismutase activity is a manifestation of the acute inflammatory stage of rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1987

Expression of HLA-DR, DQ and DP antigens and interleukin-2 receptor on synovial fluid T lymphocyte subsets in rheumatoid arthritis: evidence for "frustrated" activation.

Synovial fluid and peripheral blood T lymphocytes were examined from 10 patients with rheumatoid arthritis and 2 controls. T lymphocytes from inflammatory fluids were activated as shown by their increased size and expression of class II MHC antigens. Of the T cells, 60% were DR positive, 19% DP positive and 29% DQ positive. More Leu 2a than Leu 3a cells were HLA-DR positive. In contrast, few T cells expressed Tac. We conclude that T cell activation is taking place but is incomplete or "frustrated".

Adult↗
PubMed1994

Group II phospholipase A2 in synovial fluid and serum in acute arthritis.

Increased catalytic activity of synovial-type (group II) phospholipase A2 (syn-PLA2), has been associated with cartilage erosions in rheumatoid arthritis and osteoarthritis. The catalytic activity of phospholipase A2 and the concentration of syn-PLA2 were measured in a prospective study in synovial fluid (SF) samples from 66 patients with acute knee joint effusion. The median (range) of the concentration of syn-PLA2 in SF was 210 micrograms/l (80-1480 micrograms/l) in culture-positive septic arthritis, 460 micrograms/l (270-1040 micrograms/l) in reactive arthritis, 780 micrograms/l (120-2710 micrograms/l) in osteoarthritis and 230 micrograms/l (80-1400 micrograms/l) in traumatic joint effusions. High concentrations of syn-PLA2 are found also in SF of patients with arthritides not expected to lead to permanent destruction of cartilage.

Acute Disease↗
PubMed1977

Postoperative synovial fluid. Metabolic response to meniscectomy or synovectomy.

The metabolic response of synovial tissue to surgery was investigated by synovial fluid analysis after two types of operations, medial meniscectomy and synovectomy. Analyses of intra-articular fluid were also performed in non-operated patients with traumatic effusion or chronic synovitis in the knee. It was found that the knee joint metabolism in chronic synovitis is shifted towards anaerobic glycolysis in both operated and non-operated patients whereas meniscectomized and traumatized knees are more capable of maintaining oxidative metabolism. The data also demonstrate that one of the main reasons for decreased oxygen supply on the articular surface after meniscectomies or synovectomies is excessive intra-articular effusion which, according to earlier investigations, produces pressure in the joint cavity and inhibits local capillary circulation.

Adult↗
PubMed1985

Antiglycolipid antibodies in normal and pathologic human sera and synovial fluids.

Antiglycolipid antibodies were measured in normal and pathologic sera and synovial fluids by means of a modified microplate method of complement-mediated immune lysis of fluorescent dye-trapped liposomes. All sera of normal subjects had antibodies against globopentaosylceramide (IV3 GalNAcGbOse4Cer), ganglioside GM1, gangliotriaosylceramide, gangliotetraosylceramide, and galactosylneolactotetraosylceramide antigens. Most sera of normal subjects had antibodies against lactotriaosylceramide, N-glycolylneuraminosyl-neolactotetraosylceramide (NeuGcnLcOse4Cer), GM3 ganglioside with N-glycolylneuraminic acid (NeuGcGM3) and GD1a antigens. Differences of titers against IV3GalNAcGbOse4Cer, neolactotetraosylceramide, NeuGcGM3 and NeuGcnLcOse4Cer antigens were observed between sera of normal subjects and pathologic sera from cases of leukemias, lymphomas, several autoimmune diseases and liver diseases.

Adult↗
PubMed1981

Synovial fluid lactic acid in septic arthritis.

Lactic acid concentrations in the synovial fluid of 71 patients with inflammatory arthritis were determined by an enzyme method. In 63 samples from 54 patients with a variety of non-septic arthritides, including rheumatoid arthritis, reactive arthritis and gout, the concentration of lactic acid was never greater than 10.2 mmol/l, whereas all twelve patients with septic arthritis had concentrations of 11 mmol/l or greater. Two patients with gonococcal arthritis did not have raised lactic acid concentrations. The enzyme method of lactic acid estimation is an accurate reproducible means of differentiating septic from nonseptic arthritis prior to the isolation of the infecting organism. However, caution is necessary when interpreting the results in those patients who have recently received antibiotic therapy, or in whom gonococcal arthritis is suspected.

Arthritis, Infectious↗
PubMed1975

[Importance of enzymes in the synovial fluid. Progress report].

The significance and importance of investigation of the synovial fluid enzymes in the main arthropathies are explanined. Tables are given for the main enzymes studied, the cell compartments of origin, and data for their values in rheumatic diseases (as reported in the literature). Stress is laid on the importance of enzymes belonging to the lysosomial compartment, both in the pathogenesis of the underlying inflammation and in the relation to anatomopathological lesions in the joints. Attention is directed to the most widely accepted hypotheses. These ten to see enzymes increases in breakdown of condrocytes, as inflammatory arthritis attributable to synoviocytes and leukocytes. A personal opinion based on prior research is also presented. Further work in this sector is urged a mean of learning more about the pathology of rheumatic diseases.

Arthritis, Infectious↗