Summary
Rheumatoid arthritis (RA) is an inflammatory disease of the synovial membrane, which results in the destruction of joints by inflammatory pannus. The synovial membrane shows proliferation and cellular infiltrates on microscopy with signs of chronic and acute inflammation. Macrophages are thought to play a central role in the pathogenesis of RA. We examined synovial membrane specimens of 21 RA patients using morphological, immunohistological and enzyme histochemical methods for number and distribution of macrophages. We were able to identify 41.5±8.8% of lining cells as macrophages, depending on the method used. In abundant diffuse lymphocellular infiltrates, 23.4±11.1% of mononuclear cells were macrophages. In addition, most cells in the region of tumorlike proliferation and a stromal population of fibroblastlike cells were detected by macrophage markers. Although cell number in synovial membrane increases drastically, we did not find correlations between the relative amount of macrophages in these regions and basic activity. Basic activity includes proliferative reaction as well as lymphoplasmacellular and mononuclear infiltration-both signs of an immunopathological process. In contrast, using enzymes or activation markers, there was a clear correlation. We consider that a constant high percentage of macrophages in RA synovial membrane is present regardless of any actual in flammatory process.
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References
Geiler G (1980) The pathogenesis of rheumatoid arthritis. Z Gesamte Inn Med [Suppl] 35: 152–157
Geiler G, Emmrich J (1980) Synovial membrane changes in early rheumatoid arthritis. I. Histological studies. Z Rheumatol 39: 33–45
Schuhmacher HR, Kitridou RC (1972) Synovitis of recent onset. Arthritis Rheum 15: 465–485
Fassbender HG (1983) Histomorphological basis of articular cartilage destruction in rheumatoid arthritis. Coll Relat Res 3: 141–155
Geiler G (1987) Pathology of primary inflammatory and primary degenerative changes in joints. Z Gesamte Inn Med 42: 409–413
Rooney M, Condell D, Quinlan W, Daly L, Whelan A, Feighery C, Bresnihan B (1988) Analysis of the histological variation of synovitis in rheumatoid rrthritis. Arthritis Rheum 31: 956–963
Geiler G, Stiehl P (1974) Zur Bedutung der Begriffe Basisaktivität und Aktuelle Aktivität in der morphologischen Beurteilung der Synovialmembran bei Rheumatoid-Arthritis. Z Rheumatol 33: 73–86
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al. (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31: 315–324
Parwaresch MR, Radzun HJ, Feller AC,Peters KP, Hansmann ML (1983) Peroxidase-positive mononuclear leukocytes as possible precursors of human dendritic reticulum cells. J Immunol 131: 2719–2725
Lojda Z, Gossraw R, Schiebler TH (1976) Enzymhistochemische Methoden. Springer, Berlin Heidelberg New York
Emmrich J, Geiler G (1980) Changes in the synovial membrane in early diagnosed cases of rheumatoid arthritis. II. Immunohistochemical and serological studies. Z Rheumatol 39: 157–169
Harada T, Ugai K, Hirohata K (1989) Interaction of macrophages with rheumatoid articular cartilage. Kobe J Med Sci 35: 201–216
Koch AE, Burrows JC, Skoutelis A, Marder R, Domer PH, Anderson B, Leibovich SJ (1991) Monoclonal antibodies detect monocyte/macrophage activation and differentiation antigens and identify functionally distinct subpopulations of human rheumatoid synocial tissue macrophages. Am J Pathol 138: 165–173
Hanly JG, Pledger D, Parhhill W, Roberts M, Gross M (1990) Phenotypic characteristics of dissociated mononuclear cells from rheumatoid synovial membrane. J Rheumatol 17: 1274–1279
Konttinen YT, Reitamo S, Ranki A, Hayry P, Kankaanapaa U, Wegelius O (1981) Characterization of the immunocompetent cells of rheumatoid synovium from tissue sections and eluates. Arthritis Rheum 24: 71–79
Burmester GR, Locher P, Koch B, Winchester RJ, Dimitriu Bona A, Kalden JR, Mohr W (1983) The tissue architecture of synovial membranes in inflammatory and non-inflammatory joint diseases. I. The localization of the major synovial cell populations as detected by monoclonal reagents directed towards Ia and monocyte-macrophage antigens. Rheumatol Int 3: 173–181
Iguchi T, Kurosaka M, Ziff M (1986) Electron microscopic study of HLA-DR and monocyte/macrophage staining cells in the rheumatoid synovial membrane. Arthritis Rheum 29: 600–613
Burmester GR, Dimitriu Bona A, Waters SJ, Winchester RJ (1983) Identification of three major synovial lining cell populations by monoclonal antibodies directed to Ia antigens and antigens associated with monocytes/macrophages and fibroblasts. Scand J Immunol 17: 69–82
Theofilopoulos AN, Carson DA, Tavassoli M, Slovin SF, Speers WC, Jensen FB, Vaughan JH (1980) Evidence for the presence of receptors for C3 and IgGFc on human synovial cells. Arthritis Rheum 23: 1–9
Geiler G, Riedel U (1987) Detection by the PAP technique of lysozyme containing synoviozytes and their quantity in rheumatoid arthritis and osteoarthritis. Immunol Pol 12: 9–12
Wilkinson LS, Worrall JG, Sinclair HD, Edwards JC (1990) Immunohistological reassessment of accessory cell populations in normal and diseased human synovium. Br J Rheumatol 29: 259–263
Dinther Janssen AC van, Pals ST, Scheper R, Breedveld F, Meijer CJ (1990) Dendritic cells and high endothelial venules in the rheumatoid synovial membrane. J Rheumatol 17: 11–17
Baker DG, Dayer JM, Roelke M, Schumacher HR, Krane SM (1983) Rheumatoid synovial cell morphologic changes induced by a mononuclear cell factor in culture. Arthritis Rheum 26: 8–14
Waalen K, Forre O, Teigland J, Natvig JB (1987) Human rheumatoid synovial and normal blood dendritic cells as antigen presenting cell-comparison with autologous monocytes. Clin Exp Immunol 70: 1–9
Wilkinson LS, Pitsillides AA, Worrall JG, Edwards JCW (1992) Light microscopic characterization of the fibroblastlike synovial intimal cell (synoviocyte). Arthritis Rheum 35: 1179–1184
Lafyatis R, Thompson NL, Remmers EF, Flanders KC, Roche NS, Kim SJ, Case JP, Sporn MB, Widder RL (1989) Transforming growth factor-beta production by synovial tissues from rheumatoid patients and streptococcal cell wall arthritic rats. Studies on secretion by synovial fibroblastlike cells and immunohistologic localization. J Immunol 143: 1142–1148
Kafka SP, Phipps R, Ryan D, Looney RJ (1992) Fibroblast heterogenity in rheumatoid synovium. Arthritis Rheum 35: S231
Kulka B (1980) Quantitative Bestimmung der Immunglobuline IgG, IgA und IgM sowie der Komplement-Komponente C3c in der Synovialmembran von Kniegelenken bei Rheumatoid-Arthritis zur Objektivierung der lokalen immunologischen Aktivität. Dissertation. Leipzig
Nawka A (1984) Morphometrische Untersuchungen an der rheumatischen Synovialitis zur Objektivierung der Basisaktiviät. Dissertation. Leipzig
Claus C, Geiler G (1978) Histochemische Untersuchungen von Dehydrogenasen und lysosomalen Enzymen an der Synovialmembran bei Rheumatoid-Arthritis unter Berücksichtigung der lokalen Entzündungsaktivität. Z Rheumatol 37: 410–423
Riedel U, Geiler G (1989) Immunohistochemical studies of the synovial membrane in rheumatoid arthritis and osteoarthrosis for quantifying lysozyme and alpha-1-antitrypsin positive mononuclear cells. Z Rheumatol 48: 301–306
Radzun HJ, Parwaresch MR, Feller AC, Hansmann ML (1984) Monocyte/macrophage-specific monoclonal antibody Ki-M1 recognizes interdigitating reticulum cells. Am J Pathol 117: 441–450
Radzun HJ, Parwaresch MR (1983) Differential immunohistochemical resolution of the human mononuclear phagocyte system. Cell Immunol 82: 174–183
Parwaresch MR, Radzun HJ, Hansmann ML, Peters KP (1983) Monoclonal antibody Ki-M4 specifically recognizes human dendritic reticulum cells (follicular dendritic cells) and their possible precursor in blood. Blood 62: 585–590
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Sack, U., Stiehl, P. & Geiler, G. Distribution of macrophages in rheumatoid synovial membrane and its association with basic activity. Rheumatol Int 13, 181–186 (1994). https://doi.org/10.1007/BF00390265
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DOI: https://doi.org/10.1007/BF00390265