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Ultrastructural characteristics of synovial effusion cells in some arthropathies

Kapitonova,, M.Yu. and Othman , M. (2004) Ultrastructural characteristics of synovial effusion cells in some arthropathies. Malaysian Journal of Pathology, 26 (2). pp. 73-87. ISSN 0126-8635

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Official URL: http://www.mjpath.org.my/past_issue/MJP2004.2/01%20Arthropathies.pdf

Affiliations

University Sains Malaysia, Kelantan

Abstract

Objective: To evaluate the range of activation changes of polymorphonuclear leukocytes (PMN) and
the ratio of apoptosis and necrosis in synovial effusions of patients with various arthropathies, and
to reveal possible correlations with clinical variants of joint inflammation. Methods: Synovial
effusions were aspirated from the knee joints of patients with rheumatoid arthritis (RA, 28 cases),
and seronegative spondyloarthritides (SSA): Reiter’s disease (RD, 9 cases), peripheral form of the
ankylosing spondyloarthritis (6 cases) and psoriatic arthritis (6 cases); and primary osteoarthritis
(OA, 9 cases). Cytospin preparations were processed for transmission electron microscopy and
assessed for the incidence of apoptosis, necrosis, and cytophagocytic cells (CPC) in the synovial fluid
(SF). The range of activation changes of the neutrophil granulocytes, the dominating cell population
in the arthritic SF, was evaluated. Results: In all arthropathies under investigation most of the
synovial effusion cells had intact ultrastructure with a certain amount of apoptotic cells dominating
over the cells with signs of necrosis, and a few CPC. The highest rate of apoptosis was discovered
in the synovial effusions of patients with RA, the lowest in those with OA, while the rate of CPC
among the inflammatory joint diseases was the lowest in RA. In RA the current disease activity
correlated with the incidence of apoptotic cells and CPC, while the clinical stage was related only
to the CPC rate. These data suggest that in RA, despite exposure to the anti-apoptotic signals,
apoptosis of the synovial effusion PMN is maintained at a significantly higher level than in nonrheumatoid
arthropathies, both inflammatory (SSA) and degenerative (OA), providing elimination
of the neutrophils accumulating in the joint cavity and thus stimulating resolution of the joint
inflammation.

Item Type:Journal
Keywords:Key words: synovial effusion, rheumatoid arthritis, Reiter’s disease, ankylosing spondyloarthritis, psoriatic arthritis, osteoarthritis, transmission electron microscopy, neutrophil granulocyte, cell death
Subjects:R Medicine
ID Code:1836

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