Synovial Biopsy

Tak, P.P. and Bresnihan, B. (2000) The pathogenesis and prevention of joint damage in rheumatoid arthritis advances from synovial biopsy and tissue analysis. Arthritis and Rheumatism, 43,2619-2633. 

For instance, carbon fibers have been used widely for orthopedic applications. Matrices of carbon fibers were implanted in patients for the treatment of chronic painful articular defects of the patella [47], with mixed results at 33 months mean follow-up with low patient satisfaction. Synovial biopsies have pointed out consistent seeding of the joint with diffuse carbon fiber debris and histiocytic giant-ceU reaction in the synovium, sometime associated with low-grade inflammatory response. These results discouraged further procedures for lesions of the articular cartilage of the patella with carbon fiber matrix. 

Case 7 is also of particular interest. Arthroscopy and synovial biopsy in a patient with S.L.E., who had a mild chronic synovitis but no history of acute arthritis, showed, unexpectedly, urate crystal deposition. 

P.P. Youssef, etal. Variability in cytokine and cell adhesion molecule stainingin arthroscopic synovial biopsies Quantification using color video image analysis, /. Rheumatol, 24 (12), 2291-2298,1997. 

In the clinic, PK/PD relationships with the direct pharmacological effect, reduction of target mRNA and protein as the response measure, have been demonstrated in two studies with 2 -MOE partially modified ASOs [42, 50]. In a Phase Ila study in patients with rheumatoid arthritis, ISIS 104838 was targeted at the mRNA of TNF-a (a cytokine which is important in immune response and inflammation). The results showed that TNF-a mRNA and protein reduction in synovial tissue biopsies correlated positively with concentrations of ISIS 104838 in the synovial tissues [50]. Another investigation of PK/PD relationships was conducted in a Phase II doseranging study in prostate cancer patients treated with OGX-Oll, a 2 -MOE partially... 

These abilities that new technology offer is of high importance in, for instance, clinical studies, where in many situations there are only limited amounts of, e.g., biofluids such as synovial fluid, or tissue biopsies. There is also an ethical aspect of what sampling steps actually can be performed in human clinical studies in order not to risk the health and well-being of the patients. It is also a fact that when clinical studies are being done, some of the patient groups, for in-... 

Urate crystals in synovial punch biopsy Subcutaneous tophi... 

The patients had a much greater frequence of nephrolithiasis, crystalline urate deposits in synovial punch biopsies and were somewhat more tophaceous than expected.The severity of their gout was confirmed by the high incidence of radiographic finding of bone erosions and by the high number of joints involved for each patient. 

He was referred to Guy s for assessment and treatment of his gouty arthritis in 1980, and was admitted with swelling and tenderness of the left knee, the right elbow and MTP joint of the left foot. Urate crystals were identified in synovial fluid. He had no evidence of gouty tophi. Plasma urate was 0.60 and climbed to O.95mmol/1 (Vickers method). Liver biopsy to investigate persistently raised alkaline phosphatase, SCOT and 5 nucleotidase was normal. 

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