Synovial fluid in rheumatoid arthritis

The Structure of the Hyaluronic Acid Component of Synovial Fluid in Rheumatoid Arthritis," S. A. Barker, S. H. I. Bayyuk, J. S. Brimacombe, C. F. Hawkins, and M. Stacey, Clin. Chim. Acta, 9 (1964) 339-343. 

Marklund, S.L., Bjelle, A. and Elmqvist, L. (1986). Superoxide dismutase enzymes of the synovial fluid in rheumatoid arthritis and in reactive arthritides. Ann. Rheum. Dis. 45, 847-851. 

Selected entries from Methods in Enzymology [vol, page(s)] Cobra venom phospholipase A2 Naja naja naja, 197, 359 phospholipase A2 from rat liver mitochondria, 197, 365 assay and purification of phospholipase A2 from human synovial fluid in rheumatoid arthritis, 197, 373 purification of mammalian nonpan-creatic extracellular phospholipases A2, 197, 381 spleen phospholipases A2, 197, 390 purification and characterization of cytosolic phospholipase A2 activities from canine myocardium and sheep platelets, 197, 400. 

Nl. XSnto, V, Seppala, P., and Kulonen, E., Effect of hydrocortisone administration on the hyaluronic acid fractions of synovial fluid in rheumatoid arthritis. Clin. Chim. Acta 7. 794-799 (1962). 

Rl. Ragan, C., and Meyer, K., The hyaluronic acid of synovial fluid in rheumatoid arthritis. J. Clin. Invest. 28, 56-59 (1949). 

Ottonello L, Frumento G, Arduino N, Bertolotto M, Mancini M, Sottofattori E, Dallegri F, Cutolo M Delayed neutrophil apoptosis induced by synovial fluid in rheumatoid arthritis Role of cytokines, estrogens, and adenosine. Ann NY Acad Sci 2002 966 226-231. 

SeppSla, P., Lehtonen, A., Karkkainen, J., and Nanto, V., The presence of chondroitin sulphate in the synovial fluid in rheumatoid arthritis. Clin. CMm. Acta 16, 115-119 (1967). 

Chemoattractants induce release of arachidonic acid from phospholipids in PMNL [244] and the arachidonate metabolism is stimulated in a manner similar to that of ionophore A23187 [235,245], Inhibitors of arachidonate metabolism inhibit leukocyte migration [246-248], However, with inhibition mainly of the cyclooxygenase pathway, an increase of PMNL migration is observed in vitro [ 150,247,249] and in vivo [6,250,251], Formation of LTB and 5-HETE is significantly increased in synovial fluid in rheumatoid arthritis [40], These data support the concept that an endogenous lipoxygenase product is involved in the PMNL chemotactic response. 

Giera, M., A. loan-Facsinay et al. 2012. Lipid and Upid mediator profiling of human synovial fluid in rheumatoid arthritis patients by means of LC-MS/MS. 

Glycoproteins similar to the IDGFs are found in mammals and may constitute a novel class of cytokines, some of which are important in inflammation. The best characterized is the human glycoprotein HC gp-39 (= YKL40 16-23% identical to IDGFs), which accumulates in the synovial fluid of rheumatoid arthritis... 

Mechanism of Action Aprotein that binds to tumor necrosis factor (TNF), blocking its interaction with cell surface receptors. Elevated levels of TNF, which is involved in inflammatory and immune responses, are found in the synovial fluid of rheumatoid arthritis patients. Therapeutic Effect Relieves symptoms of rheumatoid arthritis. Pharmacokinetics Well absorbed after subcutaneous administration. Half-life 115 hr. 

Inflammation of the synovial joints in rheumatoid arthritis includes this change in the synovial fluid. 

Choy EH, Connolly DJ, Rapson N, Jeal S, Brown JC, Kingsley GH, Panayi GS, Johnston JM. Pharmacokinetic, pharmacodynamic and clinical effects of a humanized IgGl anti-CD4 monoclonal antibody in the peripheral blood and synovial fluid of rheumatoid arthritis patients. Rheumatology (Oxford) 2000 39(10) 1139-46. 

A remarkable increase in SOD-mimetic activity was found in a comparison of synovial fluid from rheumatoid arthritis and osteoarthritic patients with normal control values [613]. The increase in SOD-mimetic activity correlated with increased rheumatoid disease activity and increasing progression of disease severity. There was also a good correlation between SOD-mimetic activity and C-reactive protein in synovial fluid from patients with rheumatoid arthritis. This SOD-mimetic activity may be attributed to either an elaboration of ceruloplasmin by synovial cells [614] or the liver along with copper albumin and amino-acid copper complexes which, in part, accounts for the established increase in synovial fluid copper and ceruloplasmin in rheumatoid arthritis [30] and it is well known that ceruloplasmin [102, 489, 615] as well as amino-acid and other small-molecular-weight copper complexes have SOD-mimetic activity [287-295, 327]. 

Huang, J., Takeda, Y., Watanabe, T., and Sendo, F., 2001. A sandwich ELISA for detection of soluble GPI-80, a glycosylphosphatidyl-inositol (GPI)-anchored protein on human leukocytes involved in regulation of neutrophil adherence and migration-its release from activated neutrophils and presence in synovial fluid of rheumatoid arthritis patients. Microbiology and Immunology. 45 467-471. 

In rheumatoid arthritis the damage that is found in joints may also be a result of the inactivation of a-1-PI due to the oxidation of an essential methionine(s) residue in this protein. It has been found that a-l-PI purified from the synovial fluid of patients with rheumatoid arthritis contained four Met(O) residues and was not able to form a binary complex with elastase89. It is probable that the presence of the Met(Oj residues in a-l-PI from these patients results from a high level of oxidants produced by neutrophils in the inflammed joint. 

Kofoed, J.A. and Barcelo, A.C. (1978). The synovial fluid hyaluronic acid in rheumatoid arthritis. Experimentia 34, 1545. 

Rowley, A., Gutteridge, J.M.C., Blake, D.R, Farr, M. and Halliwell, B. (1984). Lipid peroxidation in rheumatoid arthritis thiobarbituric acid reactive material and catalytic iron salts in synovial fluid from rheumatoid patients. Clin. Sci. 66, 691-695. 

Katschke KJ Jr, Rottman JB, Ruth JH, et al. Differential expression of chemokine receptors on peripheral blood, synovial fluid, and synovial tissue monocytes/mac-rophages in rheumatoid arthritis. Arthritis Rheum 2001 44(5) 1022-1032. 

Articulated joints between bones, for example at the knee, are covered in a capsule enclosing a space, which contains synovial fluid. The lining of the capsule is composed by the synovial membrane it is this synovium that becomes inflamed in rheumatoid arthritis (RA). Secretions produced by inflammatory cells (lymphocytes, macrophages... 

Pfizer s tenidap (CP-66,248) (157), another enolic compound, was also more potent (500-fold) toward CO over 5-LO inhibition in human ISN (0.032 /iM and 18 /iM, respectively) [379-381]. Efficacy in rheumatoid arthritis clinical trials has been reported [380,382] in patients, serum levels of acute phase proteins and synovial fluid levels of IL-1 were reduced by tenidap, in contrast to the lack of this effect with NSAIDs. Besides CO/5-LO inhibition, a variety of in vitro activities have been reported, including a number of effects on monocyte functions and differentiation [379], inhibition of neutrophil degranulation [382], inhibition of the activation of neutrophil collagenase [383], inhibition of leukocyte-endothelial cell adhesion [384], and inhibition of LTB4-induced neutrophil chemotaxis [385]. Al-... 

Anakinra is a nonglycosylated form of the human IL-1 receptor antagonist (IL-lra). It is produced in a recombinant Escherichia coli expression system and has an additional methionine residue at its amino terminus. In rheumatoid arthritis patients, the amount of naturally occurring IL-lra in the synovial fluid is not sufhcient to counteract the high levels of locally produced IL-1. Anakinra acts as a competitive antagonist of the type 1 IL-1 receptor and decreases the pain and inflammation produced by IL-1. It is administered as a daily subcutaneous injection. 

In rheumatoid arthritis, immune complexes are deposited in the affected joints, causing an inflammatory response that is amplified by eicosanoids. Lymphocytes and macrophages accumulate in the synovium, whereas leukocytes localize mainly in the synovial fluid. The major eicosanoids produced by leukocytes are leukotrienes, which facilitate T-cell proliferation and act as chemoattractants. Human macrophages synthesize the COX products PGE2 and TXA2 and large amounts of leukotrienes. 

H3. Halla, J. T., Volanakis, J. E., and Schrohenloher, R. E., Immune complexes in rheumatoid arthritis sera and synovial fluids A comparison of 3 methods. Arthritis Rheum. 22, 440-448 (1979). 

The maintenance of the normal, anomalous viscosity index of synovial fluid is essential for its proper function as a lubricant between joint surfaces. The concentration and the degree of polymerization of hyaluronic acid in synovial fluids of patients with rheumatoid arthritis and other degenerative joint diseases have been the subjects of widespread investigation. Ragan and Meyer (R1) ascribed the changes in synovial fluid in... 

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