Biochemical studies on synovial fluid. II. Effect of intra-articular administration of aurothiomalate on mucopolysaccharase activities in rheumatoid synovial fluid.
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Adult↗
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Results for “SYNOVIAL FLUID”
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[Study of the mechanism of the fall in complement levels in the synovial fluid in rheumatoid arthritis. II. Demonstration of an abnormal anti-complement property in rheumatoid synovial fluids].
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Arthritis↗
Identification of cartilage wear fragments in synovial fluid from equine joints.
Synovial fluids from 72 equine joints were examined for the presence of cartilage debris, and these findings were compared to findings from visual inspection of the articular cartilage surfaces at necropsy. Synovial fluids from 25 joints with visual cartilage damage contained one or more large particles of articular cartilage. Cartilage fragments were not found in synovial fluids from 42 of the 47 apparently normal joints; thus, a correlation may exist between cartilage debris in the synovial fluid and lesions of the articular surfaces.
Animals↗
Sulphydryl groups in the synovial fluid in cases of rheumatoid arthritis, reactive synovitis of local origin and in post-mortem synovial fluid.
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Adult↗
Lactoferrin in synovial fluid.
The synovial lactoferrin (LF) concentrations of 59 patients with active rheumatoid arthritis were determined. The median value of LF was 4.64+/-3.59 mg/100 ml, but in degenerative arthropathy the levels of the metal-protein were much lower and often not titratable. These variations in the LF concentration explain the low blood-iron levels in inflammatory states, even when the concentration of the metal-protein is not statistically correlated in inflammatory tests, IgG, complement fractions (of the normal or alternate pathway), or variations of other protein fractions of leucocyte origin.
Arthritis, Rheumatoid↗
[Identification of crystals in synovial fluid: joint-specific identification rate and correlation with clinical preliminary diagnosis].
The diagnostic clarification of joint effusions of unknown origin is a challenge to every primary-care physician. Important diagnostic procedures are arthrocentesis and analysis of the aspirated synovial fluid. Synovial fluid analysis frequently allows differentiation between harmless effusions due to osteoarthritis and crystal induced inflammation, or the more devastating septic arthritis. 4475 synovial fluids were evaluated retrospectively to calculate the identification rate of crystals compatible with calcium pyrophosphate dihydrate (CPPD) and monosodium urate monohydrate (MSUM). 40.8% (1827) of synovial fluids were taken from females and 59.2% (2648) from males. The frequency of crystal identification varied considerably: 13.2% CPPD crystal identification in females, 10.9% in males; MSUM was identified in 1.5% of females, and in 10.9% of males. The spectrum of joint involvement was nearly identical in CPPD and MSUM positive synovial fluids. Exceptions were the higher frequency of CPPD identification in shoulder joints (CCPD:MSUM = 15.6:1), the higher frequency of MSUM identification in the ankle (MSUM:CPPD = 15.6:1) and the first metatarsophalangeal joints (MSUM:CPPD = 8:1). Clinical suspicion correlated well with crystal identification in MSUM positive samples (60%), but was poor in CPPD positive samples (36%). The poor correlation between clinical suspicion and crystal identification in CPPD positive synovial fluids is explicable by the less characteristic clinical presentation of pyrophosphate arthropathy in contrast to classical gout. A high percentage of crystal identification was found in joints or periarticular swellings in which aspiration is difficult and therefore rare (e.g. tendon sheaths, first metatarsophalangeal and first metacarpophalangeal joints), underlining the importance of synovial fluid aspiration despite the difficulty of arthrocentesis.
Adolescent↗
Synovial fluid lipids in rheumatoid arthritis.
Synovial fluid from the inflamed knee joints of 30 patients with rheumatoid arthritis (RA) contained 2.75 +/- 0.81 mmol/l cholesterol (51% of the corresponding mean serum level) and 0.32 +/- 0.13 mmol/l triglycerides (35% of the corresponding mean serum level). The ratio of synovial fluid triglycerides to cholesterol indicates that in RA the concentration of very low density lipoproteins (VLDL) is lower in synovial fluid than in serum. In a few patients, however, the "relative triglyceride concentration" in synovial fluid (i.e. synovial fluid tg/chol:serum tg/chol) was greater than 1. This concentration did not correlate, moreover, with the clinical activity of the disease.
Adult↗
The relevance of chondroitin and keratan sulphate markers in normal and arthritic synovial fluid.
This study investigated the synovial fluid concentrations of glycosaminoglycan (GAG), keratan sulphate (KS) epitope 5D4 and chondroitin sulphate (CS) sulphation patterns in healthy volunteers and patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Synovial fluids were collected from knee joints of healthy volunteers (n = 24), and patients with OA (n = 28) and RA (n = 29). Concentrations of GAG and the keratan sulphate epitope 5D4 were measured in 15 of the healthy volunteers, and all of the OA and RA synovial fluids. Total GAG was measured using a dye-binding method and 5D4 by an ELISA. The unsaturated CS disaccharides delta C4 and delta C6 were measured by capillary electrophoresis in all synovial fluids. The concentrations of GAG, 5D4 and delta C6 in the normal synovial fluid were higher but that of delta C4 lower than those of the disease groups. The delta C6:delta C4 ratios correlated with age (r = -0.437, P < 0.001) and the mean value was lower in females than males (2.92 compared with 5.22, P < 0.001). After allowing for age and sex, the delta C6:delta C4 ratio in the control group was significantly elevated (P < 0.001) compared to both OA and RA. The ratio was also related to proteoglycan markers (r = 0.383 for 5D4 and r = 0.357 for GAG). The finding that 5D4 and delta C6:delta C4 ratios are higher in synovial fluid from healthy volunteers compared to OA and RA suggests that they may be markers of the susceptibility of articular cartilage to early damage in arthritis.
Adult↗
The role of synovial fluid filtration by cartilage in lubrication of synovial joints--II. Squeeze-film lubrication: homogeneous filtration.
A mathematical model of synovial film filtration and synovial gel formation at normal approach of cartilage surfaces in the human hip joint is presented. The biphasic mixture model presented in Part I of this paper [Hlavácek, J. Biomechanics 26, (1993)] for synovial fluid and that of Mow and his collaborators [J. Biomech. Engng 102, 73-84 (1980)] for cartilage are used. A general analysis of filtration of an axially symmetric synovial squeeze-film between two cartilage layers at normal approach is given. The geometrically simple case much idealising the human hip joint is also considered: two cartilage discs with a synovial film in between are compressed by the steady loading of the half human weight. The homogeneous film filtration process where the synovial gap remains parallel and the macromolecular concentration in the gap is spatial homogeneous (to the thin-film approximation) and time-dependent is numerically analysed. If the hyaluronic acid concentration of the synovial gel at equilibrium is 50 mg/ml at least, the resulting stable gel layer thickness for the homogeneous filtration in the human hip joint and for normal synovial fluids is about 0.1 micron, being almost independent of the loading. Inflammatory synovial fluid shows values several times lower.
Adhesiveness↗
Characteristics of normal equine tarsal synovial fluid.
Physical, biochemical, and cytologic properties of synovial fluid from normal equine tarsal joints were investigated. Tarsal synovial fluid was pale yellow, clear, free of flocculent material, and did not clot. Volume varied in direct proportion to individual tarsal joint size. Relative viscosity was related to volume, polymerization and quantity of hyaluronic acid, and protein concentration. Mucinous precipitate quality (hyaluronic acid polymerization) was uniformly high. Results of certain analyses of serum were compared with those of tarsal synovial fluid. Tarsal synovial fluid protein concentration was low in conjunction with a high A:G ratio. Serum: synovial fluid sugar ratio was 1.24:1. Serum ALP, ACP, LDH, GOT, and GPT activity levels were higher than their corresponding levels of activity in tarsal synovial fluid. Serum ALD activity level was slightly lower than its tarsal synovial fluid counterpart. Total erythrocyte counts ranged markedly, while total leukocyte counts were uniform and low. Lymphocytes were the predominant synovial fluid cell type.
Acid Phosphatase↗
Comparison of isotonic and radiometric-hypertonic cultures for the recovery of organisms from cerebrospinal, pleural and synovial fluids.
Two hundred eighteen (218) specimens of body fluids were examined by both isotonic and hypertonic culture methods. The specimens examined included 108 pleural fluids, 43 synovial fluids, and 67 cerebrospinal fluids. Organisms were recovered in 99 instances by means of the isotonic system and in 140 instances by the hypertonic system. The hypertonic system also involved the use of radiometric assay for the detection of positive cultures. In all 140 cases, detection was accomplished within 36 hours after collection of the specimen by the radiometric method, while only 26 specimens showed any visual evidence of bacterial growth. Of the 218 patients involved, 198 were receiving antimicrobial therapy in which the antimicrobial agent attacked the bacterial cell wall.
Bacteriological Techniques↗
Antibodies to immunoglobulin-G in dog sera, synovial fluids and aqueous humor: a comparative study of rheumatoid factor assays, suitable for routine application.
The incidence of anti-IgG antibodies (rheumatoid factors, RF) in body fluids (sera, synovial fluids and aqueous humor) selected from 62 normal and 275 diseased dogs was studied. Fluids were assayed by canine versions of standard agglutinating and/or precipitating RF assays with routine application in human practice. The number of RF detected by dog IgG-coated particles was substantially higher by latex fixation test (LFT) than by modified Rose-Waaler (RW) test (61/144 vs. 14/144). This did not result from false positives by LFT since latex activity was completely inhibited by aggregated dog IgG. Some evidence is presented indicating that results obtained by standard RW in particular, but also those obtained by standard LFT, might be improved by modifying testing conditions currently used. Body fluids were further studied for the presence of precipitins to aggregated dog IgG in 0.6% agarose (gel precipitation test (GPT]. The frequency of RF was higher by GPT than by LFT, both in normal control fluids (for sera 26/52 vs. 19/52) and patient material (for sera 135/197 vs. 95/197). Thus, the canine RF appear to be a serum component with an unexpectedly high frequency in both normal and diseased dogs, but grossly underestimated by the recommended routine RF assays based on agglutination. The GPT, which combines a superior detection rate of theoretically also agglutinating RF with an inability to detect RF quantitatively, seems an ideal RF 'indicator' test to dictate improvements to the quantitative LFT/RW assays so as to facilitate RF detection at clinically relevant concentrations. Thus optimized, RW/LFT would provide the optimal detection apparatus for the ultimate isolation of the relevant 'RF' repertoire present, for comparative studies aimed ultimately at unraveling the etiopathogenesis of the 'real' RF.
Animals↗
Preliminary report on cytokine determination in human synovial fluids: a consensus study of the European Workshop for Rheumatology Research. The Cytokine Consensus Study Group of the European Workshop for Rheumatology Research.
A consensus study involving several European research groups was conducted in order to assess the reliability and reproducibility of cytokine measurements in biological fluids. Six synovial fluids and one serum--some of them spiked with recombinant human cytokines--were aliquoted and distributed blindly to different laboratories. The samples were tested for tumor necrosis factor alpha (TNF-alpha), interleukin-1 alpha (IL-1 alpha) and 1 beta, IL-6, IL-2, interferon gamma (IFN-gamma), and the soluble receptors of IL-2 (IL-2R) and TNF (TNF-sR55 and -sR75), using various immunoassays and, occasionally, bioassays. The same ELISA used in different laboratories yielded comparable results, whereas different ELISAs usually detected the highest levels in the same samples, but yielded different absolute values. This finding highlights the necessity of establishing international standards for all immunoassays. Many other questions arose during this preliminary study, and further investigations are planned to clarify them.
Cytokines↗
Synovial fluid examination for the diagnosis of synovial amyloidosis in patients with chronic renal failure undergoing haemodialysis.
The diagnosis of synovial amyloidosis is based upon synovial biopsy. Synovial fluid (SF) in seven patients with amyloid arthropathy associated with chronic renal failure undergoing haemodialysis were studied. The SF and synovial samples of 10 consecutive patients with seronegative mono- or oligoarthritis served as controls. Six of the seven patients with amyloid positive synovial biopsy specimens showed amyloid in their SF. No amyloid was found in the synovial tissue or fluid of the 10 patients in the control group, the sensitivity being 87.7%. The finding of amyloid in SF was highly reproducible, showing its presence in the same joint on several occasions. The deposits were Congophilia resistant to potassium permanganate pretreatment, and the immunohistochemical analysis proved that they contained beta 2 microglobulin. The high sensitivity and good reproducibility of the method shows that the finding of amyloid in SF is sufficient for the diagnosis of synovial amyloidosis. It is possible to perform immunohistochemical analysis on the SF sediment. Amyloid arthropathy can therefore be added to the list of conditions in which synovial fluid examination can be clinically helpful.
Adult↗
Demonstration of anticollagen antibodies in rheumatoid arthritis synovial fluids by 14C-radioimmunoassay.
Twenty-seven synovial fluids from rheumatoid arthritis (RA) patients and 17 synovial fluids from controls were investigated in a new radioimmunoassay for anticollagen antibodies. In vitro labeled human 14C-collagen of type I in native or denatured state was used as antigen. Passive hemagglutination was used in comparison. Parameters for defining positive results in radioimmunoassay were evaluated on the basis of control synovial fluids. Synovial fluids from 20 RA patients (74%) showed antibodies to denatured collagen; synovial fluids from 8 RA patients (30%) also demonstrated antibodies to native collagen. Control fluids of posttraumatic effusions were negative; among the other controls synovial fluid from 1 psoriatic arthritis patient reacted positively. Inhibition experiments showed that antibodies to denatured collagen cross-reacted with native collagen. Inhibition with human denatured type III collagen displayed strong cross-reactivity of anti-type I collagen antibodies with type III collagen.
Adult↗
[6-methoxy-2-naphthylacetic acid level in plasma, synovial fluid and adjacent tissue in patients with rheumatoid arthritis or gonarthroses after a 4-day therapy with nabumetone (Arthaxan)].
The concentration of 6-methoxy-2-naphthyl acetic acid (6-MNA) in plasma, synovial fluid, synovial tissue and fibrous capsule tissue was determined in an open study with 20 patients scheduled for knee joint surgery after oral treatment with nabumetone (Arthaxan) under steady state conditions. 6-MNA is the principal metabolite of the prodrug nabumetone arising from an extensive first-pass metabolism in the liver. The patients suffering from rheumatoid arthritis (n = 12) or osteoarthritis stage III or IV (n = 8) received a daily dose of 1 g nabumetone nocte starting 4 days prior to surgery. On day 1 an additional loading dose of 1 g nabumetone was given in the morning. At the time of surgery (day 5) simultaneously blood and synovial fluid was aspirated and after medial opening of the knee joint biopsies of synovial tissue and fibrous capsule tissue were taken. The samples were analysed employing HPLC. After 4 days of treatment mean 6-MNA concentration in plasma was 40.76 micrograms/ml, in synovial fluid 34.79 micrograms/ml, in synovial tissue 19.33 micrograms/g and in fibrous capsule tissue 11.43 micrograms/g. Under steady state conditions mean synovial fluid levels of 6-MNA were higher than after application of a single dose.
Adult↗
A quantitative study of metachromasy in synovial fluid and mucin.
SPECTROPHOTOMETRIC MEASUREMENTS ON SYNOVIAL FLUID AND SOLUTIONS OF MUCIN AND HYALURONATE IN THE PRESENCE OF METHYLENE BLUE SHOWED THAT: 1. Dialyzed synovial fluid was not metachromatic. 2. Albumin and gelatin at a concentration of 1 mg. per ml. inhibited the metachromasy of strong chromotropes. 3. Reduction of the protein of synovial fluid by the use of proteolytic enzymes still did not make the synovial fluid chromotropic. 4. Mucin solutions, with a protein content equal to that of protease-treated synovial fluid, were intensely metachromatic. 5. Sulfur-free hyaluronate produced intense metachromasy. The evidence presented indicates that in its native state in synovial fluid hyaluronate is either bound or its anionic groups are not entirely free.
Coloring Agents↗
Interleukin-6 in synovial fluid from patients with arthritis.
Synovial fluid and serum from patients with rheumatoid arthritis, other inflammatory arthritides, and traumatic arthritis were assayed for the presence of interleukin-6 (IL-6) by means of an IL-6-dependent mouse hybridoma cell line. The cytokine was detected in all the samples of synovial fluid (range 50-22000 U/ml). IL-6 in synovial fluid was positively correlated (r = 0.58, P = 0.03) with the erythrocyte sedimentation rate in patients with inflammatory arthritis. In serum, the concentration of IL-6 was slightly elevated in some patients with rheumatoid arthritis. The results demonstrate that IL-6 is released into synovial fluid in joints affected by arthritis, and there appears to be an association between the levels of IL-6 and disease activity.
Adolescent↗