Document Detail


Inflammatory cell infiltrate and RANKL/OPG expression in rheumatoid synovium: comparison with other inflammatory arthropathies and correlation with outcome.
MedLine Citation:
PMID:  15895888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate if the immunofluorescence analysis of synovial tissue (ST) using antibodies against RANKL/OPG, conjugated with the immunophenotyping of lymphocytes and macrophages, could be of diagnostic and prognostic value in rheumatoid arthritis (RA) patients. METHODS: 3-year prospective study of 103 consecutive patients submitted to closed needle biopsy for diagnostic purposes. ST was analyzed with routine histologic techniques and immunofluorescence, using monoclonal antibodies against RANKL, OPG, CD163, CD68, CD4, CD8, interferon-gamma and CD19. Patients were prospectively evaluated with a clinical, laboratorial and radiological protocol. At the end of the follow-up patients were divided according to the final diagnosis. Results of the initial histologic evaluation were compared between the main diagnostic groups and in RA patients histologic data was correlated with clinical and radiologic outcome measures. RESULTS: The RANKL/OPG ratio and the inflammatory infiltrate were significatively higher in RA (n = 25) as compared to the same ratio observed in other inflammatory joint diseases (OIJD, n = 48) and in osteoarthritis (n = 17). The difference between RA and OIJD was specifically confirmed when the comparison involved spondyloarthropathy (n = 26). Final HAQ score and radiologic outcome were correlated with the density of intimal CD68+ macrophages. Radiologic progression was correlated with subintimal CD4+ lymphocytes and CD68+ macrophages and intimal CD68 and CD163+ macrophages. CONCLUSION: The quantification of the RANKL/OPG ratio and of the number of lymphocytes in the ST might be useful to differentiate RA from other inflammatory joint diseases. The ST number of CD4+ lymphocytes and macrophages are probable predictors of radiologic progression in RA patients.
Authors:
J E Fonseca; N Cortez-Dias; A Francisco; M Sobral; H Canhão; C Resende; W Castelão; C Macieira; G Sequeira; F Saraiva; J A Pereira da Silva; M Carmo-Fonseca; M Viana Queiroz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  23     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-05-17     Completed Date:  2005-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  185-92     Citation Subset:  IM    
Affiliation:
Rheumatology Department, Santa Maria Hospital, Lisbon, Portugal. jefonseca@netcabo.pt
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthritis, Infectious / diagnosis,  metabolism
Arthritis, Rheumatoid / diagnosis*,  metabolism
Biopsy, Needle
Carrier Proteins / metabolism*
Female
Fluorescent Antibody Technique, Indirect
Humans
Immunophenotyping
Lymphocytes / metabolism,  pathology*
Macrophages / metabolism,  pathology*
Male
Membrane Glycoproteins / metabolism*
Middle Aged
Osteoarthritis / diagnosis,  metabolism
Prognosis
Prospective Studies
RANK Ligand
Receptor Activator of Nuclear Factor-kappa B
Synovial Membrane / metabolism,  pathology*
Chemical
Reg. No./Substance:
0/Carrier Proteins; 0/Membrane Glycoproteins; 0/RANK Ligand; 0/Receptor Activator of Nuclear Factor-kappa B; 0/TNFRSF11A protein, human; 0/TNFSF11 protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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