共抑制分子PD-1在类风湿关节炎模型免疫系统及滑膜组织的表达

目的:探讨共抑制分子PD-1在牛二型胶原(CII)诱导的类风湿关节炎模型(CIA)小鼠免疫器官、关节及RA患者滑膜组织内的表达.方法:使用牛二型胶原免疫DBA-1/j小鼠,建立小鼠类风湿关节炎模型;免疫组化检测类风湿关节炎标本PD-1的表达变化;流式细胞分析术(FACs)检测对PD-1阳性细胞进行定位.结果:免疫组化的结果证实,小鼠的骨髓、胸腺、脾脏及淋巴结有中有大量的PD-1阳性细胞,FACs分析结果表明这些PD-1+ 细胞主要为CD3+T细胞,B220+B细胞,CD68+巨噬细胞及CD11c+树突状细胞,统计分析表明CIA小鼠体内PD-1表达及分布相对于对照组小鼠没有显著提高.此外,RA患者及CIA小鼠的滑膜组织内仅发现少量PD-1阳性的细胞. 结论:PD-1阳性细胞可能不参与类风湿性关节炎的发生发展过程.     

B7-H4在类风湿关节炎组织内的表达及分布研究

为探讨共刺激分子B7-H4在牛Ⅱ型胶原(CⅡ)诱导的类风湿关节炎(CIA)模型小鼠免疫器官、关节及RA患者滑膜组织内的表达,使用牛Ⅱ型胶原免疫DBA-1/j小鼠,建立小鼠类风湿关节炎模型.免疫组化检测B7-H4的表达变化,结果证实小鼠的胸腺、脾脏及淋巴结中有大量的B7-H4阳性细胞,免疫荧光分析结果表明这些B7-H4+...     

共刺激分子HVEM在类风湿关节炎滑膜组织内的表达及分布研究

目的探讨TNF家族共刺激分子HVEM(herpesvirus entry mediator)在类风湿关节炎(RA)患者滑膜组织内的表达及分布。方法使用免疫组化法检测RA患者滑膜组织HVEM的表达;并使用免疫荧光法检测HVEM的细胞定位及分布。结果免疫组化结果证实,RA患者滑膜组织中有大量的HVEM阳性细胞,形态观察提示这些阳性的细胞主要是毛细血管、滑膜细胞、局部淋巴结T细胞及巨噬细胞;免疫荧光分析进一步表明这些HVEM+细胞主要为CD3+T细胞,CD68+巨噬细胞,少数CD31+内皮细胞也表达HVEM,但其不表达于CK-18+上皮细胞。对比其他B7家族共刺激分子在滑膜组织中的分布,免疫荧光发现HVEM共表达于B7-H3+血管,但不表达于B7-H1+、B7-DC+、B7-H4+及Z39Ig+细胞。结论关节炎滑膜组织内有大量HVEM阳性细胞,提示HVEM有可能参与并调节了关节炎的病理进程。     

B7-H3在类风湿关节炎患者滑膜组织内的表达及分布研究

探讨B7家族共刺激分子B7-H3在类风湿关节炎(RA)患者滑膜组织内的表达及分布。方法:使用免疫组化法检测RA患者滑膜组织B7-H3的表达,并使用免疫荧光法检测B7-H3在细胞中的定位及分布。结果:免疫组化结果证实,RA患者滑膜组织中有大量的B7-H3阳性细胞,形态观察提示这些阳性的细胞主要为毛细血管细胞、滑膜细胞、局部淋巴结处的T细胞及巨噬细胞;免疫荧光分析进一步表明这些B7-H3+细胞主要为CD68+巨噬细胞,CD31+内皮细胞及CK-18+上皮细胞。此外,对比其他B7家族共刺激分子在滑膜组织中的分布,免疫荧光发现B7-H3共表达于B7-DC+及HVEM+血管,但不表达于B7-H1+及B7-H4+细胞。类风湿关节炎滑膜组织内有大量B7-H3阳性细胞,提示B7-H3有可能参与并调节关节炎的病理进程。     

类风湿关节炎滑膜组织及关节液中DcR3表达的研究

目的:观察研究人诱骗受体3(DcR3)在类风湿关节炎(RA)关节液及滑膜组织中的表达及其与滑膜炎性病变程度的相关性.方法:用免疫组织化学的方法对12例RA患者、6例骨关节炎(OA)患者及4例无关节病变的骨折患者滑膜组织中DcR3的表达进行描述分析,并对DcR3表达情况与RA患者滑膜炎性病变程度相关性进行分析.同时用ELISA的方法检测了26例RA及19例OA患者关节液中DcR3的表达.结果:DcR3在RA滑膜组织主要分布于血管翳周围炎性细胞及部分滑膜细胞中,DcR3阳性细胞数约为72％.OA滑膜组织细胞中DcR3也呈现少量的阳性表达,但与RA比较阳性程度较弱,阳性细胞数量较少:对DcR3表达与RA滑膜炎性程度的相关性分析发现,DcR3与RA滑膜炎性程度呈正相关(r=0.832,P＜0.01),同时发现RA患者关节液中表达也明显高于OA患者.结论:DcR3在RA滑膜组织炎性细胞及滑膜细胞上的异常表达可能是其参与RA滑膜炎及滑膜组织侵袭等病理过程,从而导致滑膜损伤的一个重要机制.     

CyclinB1和CyclinD3基因在类风湿关节炎滑膜组织中的表达

滑膜衬里层增厚是类风湿关节炎的重要病理学特征之一，但机制不清。本研究用核酸分子原位杂交技术检测反映细胞增殖状况的细胞周期蛋白基因ＣｙｃｌｉｎＢ１和ＣｙｃｌｉｎＤ３在１０例ＲＡ、３例骨关节炎及４例正常关节滑膜组织的ｍＲＮＡ表达水平。发现ＣｙｃｌｉｎＢ１ｔ ＣｙｃｌｉｎＤ３在ＲＡ滑膜衬里层表达明显高于对照组，提示滑膜细胞的原位增殖在ＲＡ滑膜衬里层增厚中可能起一定作用。     

类风湿关节炎患者滑膜组织和外周血CD4+T细胞的凋亡分析

类风湿关节炎 (RheumatoidArthritis ,RA)是一种累及全身多关节的自身免疫性炎症性疾病 ,其病理特征之一为炎性滑膜浸润大量CD4 + T细胞 ,滑膜细胞增生及血管翳形成 ,其机理仍未阐明。有学者认为RA的发病与细胞凋亡过程异常有关 ,并有多种细胞参与 ,包括滑膜细胞、成纤维细胞、淋巴细胞、软骨细胞等[1] 。本实验应用末端脱氧核苷酸转移酶介导的缺口末端标记法 (TUNEL)和流式细胞术 ,探讨细胞凋亡在RA发病机制中的作用。1　材料与方法1 1　标本　RA患者滑膜组织和外周血取自 8例RA病人 ,RA诊断根据 1987年美国风湿病学会(ACR)修订…     

类风湿关节炎滑膜组织T7噬菌体展示cDNA文库的构建

目的构建类风湿关节炎(RA)滑膜组织T7噬菌体展示cDNA文库,为筛选和鉴定RA特异性基因的研究奠定基础。方法取确诊RA患者的滑膜组织,用Trizol试剂提取总RNA,Oligotex离心柱分离mRNA,电泳检测其质量,逆转录合成双链cDNA,经末端修平、接头连接、酶切后去除过多接头,收集>300bp的cDNA片段,与T7Select10-3载体连接,体外包装并扩增得到类风湿关节炎滑膜组织T7噬菌体展示cDNA文库。最后,通过铺平板滴度测定及PCR技术鉴定文库质量。结果所构建原始文库重组克隆数为2×107pfu,扩增滴度8.9×1010pfu/ml。PCR法检测片段插入率为90%,插入片段在300～2000bp之间。文库噬菌体裂解液PCR扩增得到BiP基因片段。结论成功构建了高质量的RA滑膜T7噬菌体展示cDNA文库,为下一步RA自身抗原的筛选奠定了基础。     

类风湿关节炎患者关节滑膜液淋巴细胞活化标志的表达及意义

目的:研究类风湿关节炎(rheumatoidarthritis,RA)患者关节滑膜液淋巴细胞活化标志CD69、CD25、CD71、HLA-DR的表达,探讨其在RA致病中的作用。方法:采用流式细胞仪检测RA患者关节滑膜液淋巴细胞活化标志CD69、CD25、CD71、HLA-DR的表达,并设立正常对照组。结果:RA患者关节滑膜液表达CD25和CD71的淋巴细胞与正常对照组相比明显增多(P<0.01);而表达CD69和HLA-DR的淋巴细胞,与正常对照组相比差异无显著性(P>0.05)。结论:关节滑膜液淋巴细胞活化标志的表达增高,在RA发病机制中起着重要的作用。     

趋化因子CCL5/RANTES在类风湿关节炎患者滑液及滑膜中的表达

类风湿关节炎 (ＲＡ)是一种常见的慢性关节炎 ,其主要病理改变之一为大量炎性细胞在滑膜的浸润和在滑液的渗出。近期的研究显示 ,ＲＡ的这一病理改变与趋化因子 (ｃｈｅｍｏｋｉｎｅ)在病变关节产生增多有关。有报道表明ＣＣ亚族趋化因子受体 5 (ＣＣＲ5 )在ＲＡ关节浸润的炎性细胞中表达增高 ,提示ＲＡ病变关节内ＣＣＲ5的配体可能产生增多。为探讨这种可能性 ,我们对ＣＣＲ5配体ＣＣＬ5(ＲＡＮＴＥＳ)在ＲＡ关节组织中的表达进行了研究符合美国风湿病学会 1987年的ＲＡ诊断标准的ＲＡ患者 2 8例 ,男 5例 ,女 2 3例 ,平均年龄 38岁 ,平均病…     

Soluble histocompatibility antigens in synovial fluids of patients with rheumatoid arthritis

Soluble histocompatibility antigens of the class II region have been detected in synovial fluids obtained from patients with rheumatoid arthritis. A capture immunoassay involving two monoclonal antibodies was used; interference by rheumatoid factor, which is a feature of such assays, was overcome by mild pretreatment of fluids with 2-mercaptoethanol. No HLA class II antigen could be detected in matched sera from patients, even when levels were high in synovial fluids. Released HLA-class II material was of high molecular weight (greater than 1000 kD) and was linked to HLA-class I antigen. However, no significant amounts of other common cell surface antigens were detected in the complex, suggesting a preferential release of MHC antigens from cells of the inflamed synovium. Attempts to induce production of similar material from a cell line which expresses HLA class II strongly at the cell surface, by stressing the cells in various ways did not succeed, indicating that release is an active process.     

Expression of decay-accelerating factor is reduced on hyperplastic synovial lining cells in rheumatoid synovitis.

Decay-accelerating factor (DAF), a membrane inhibitor of homologous complement activation, is present in synovial cells lining joint space and detected in synovial fluid. DAF is considered to protect synovial membrane from complement-mediated injury associated with articular inflammation. We studied the immunohistopathological features of DAF molecules in synovial membrane of rheumatoid synovitis using a DAF-specific monoclonal antibody, 1C6. Reacting molecules with the 1C6 antibodies in synovial tissue extracts formed a 70-kD band in Western blot analysis. DAF was strongly detected on the flat synovial lining cells, but weakly on the hyperplastic and multi-layered lining cells in rheumatoid synovitis. The latter cells reacted with anti-Leu-M3 antibodies specific for a cell surface marker of activated macrophages, sometimes accompanied by C3 and IgM deposition on the superficial synovial membrane. These results suggest that active rheumatoid synovitis characteristically with hyperplastic synovial lining cells is out of control by DAF, thereby permitting further complement-mediated injury.     

Depressed degranulation response of synovial fluid polymorphonuclear leucocytes from patients with rheumatoid arthritis to IgG aggregates.

No difference was found between the degranulation responses to FMLP of synovial fluid (SF) polymorphonuclear leucocytes (PMNL), from patients with rheumatoid arthritis (RA), and either paired blood PMNL or blood PMNL from a healthy donor. In contrast, the response of SF PMNL to heat-aggregated IgG was often reduced compared with autologous blood PMNL. Similarly, SF from some (35%) RA patients stimulated degranulation of PMNL but the response of SF-derived PMNL to autologous stimulatory SF was reduced compared with the response of blood PMNL. The stimulatory activity of the SF was removed by sepharose-protein A. These results were taken to suggest that the activity is due to immunoglobulin aggregates and that SF PMNL (from some RA patients) are tachyphylactic to stimulation by immunoglobulin aggregates as measured by degranulation because they have been stimulated by immunoglobulin aggregates in vivo. In other studies the concentration of myeloperoxidase (MPO) was measured enzymically in RA SF and was found to be present in varying amounts. However, only a weak relationship was found between MPO levels and either PMNL numbers or levels of complement-bearing IgG aggregates in SF. It is considered that the relationship between MPO and immunoglobulin aggregates levels is obscured by the presence of a peroxidase inhibitor in the fluids and/or because only aggregates bound to tissue stimulate degranulation in vivo.     

Induction of Fas-dependent apoptosis in synovial infiltrating cells in rheumatoid arthritis

Apoptosis is a feature of the synovium of rheumatoid arthritis(RA). We have recently shown that RA synoviocytes were susceptibleto anti-Fas mAb and undergo apoptosis in vitro. To investigatewhether infiltrating mononuclear cells also undergo Fas-dependentapoptosis, double-labeling techniques combined with immunohistochemicalexamination with anti-CD3 mAb and the TdT-mediated dUTP-biotinnick end labeling (TUNEL) method to detect apoptotic cells,or in situ RT assay to detect Fas mRNA, were performed usingfrozen tissue sections. We also examined the in vitro inductionof Fas-dependent apoptosis in freshly isolated synovium infiltratingmononuclear cells (SIM), synovial stromal cells (SSC) and peripheralblood lymphocytes (PBL) using tissues from nine patients withRA and three with osteoarthritis (OA). The results showed expressionof Fas antigen and apoptotic cells in a number of CD3-bearingcells in RA synovial tissues. In vitro treatment with anti-FasmAb produced a significant apoptosis of RA SIM and SSC, whilenone of PBL, and neither SIM nor SSC from OA exhibited apoptosis.Moreover, 50% of CD4⁺, CD3⁺ and CD45RO⁺ cells, and >90% ofFas-expressing cells of RA SIM underwent apoptosis in responseto anti-Fas mAb, as detected by flow cytometry. Our resultssuggest that RA synovial infiltrating lymphocytes acquire highsusceptibility to anti-Fas mAb and undergo apoptosis. Such aphenomenon of infiltrating T cells in RA synovium may play animportant pathophysiological role and suggest a possible therapeuticeffect for anti-Fas mAb in RA.     

Expansion of a unique macrophage subset in rheumatoid arthritis synovial lining layer

The Z39Ig protein (complement receptor for C3b and iC3b) is expressed on resident tissue macrophages in various tissues. This study was undertaken to examine the distribution of Z39Ig+cells and their phenotypic features in rheumatoid arthritis (RA) synovium, in comparison with those of osteoarthritis (OA) and psoriatic arthritis (PsA) synovium. Monoclonal anti-Z39Ig antibody was produced by immunizing Z39Ig transfected murine pre B cells and used for the identification of Z39Ig+cells. Z39Ig+cells were further stained with antibodies to macrophages, fibroblast-like synoviocytes, complement receptors and dendritic cells by using the double immunostaining method in normal, RA, OA and PsA synovium. RA synovial mononuclear cells were double-stained using anti-Z39Ig and anti-CD11c antibodies and sorted into Z39Ig+CD11c+cells and Z39Ig+CD11c-cells. These cell populations were then analysed by electron microscopy. The expression of the Z39Ig protein was limited to intimal macrophages in normal, RA, OA and PsA synovium. The numbers of Z39Ig+CD11c+cells and the ratios of Z39Ig+CD11c+cells to Z39Ig+cells were increased in the synovial lining layer of RA as compared with those of OA and PsA. The ultrastructural analysis of Z39Ig+CD11c+cells showed the character of macrophages with many secondary lysosomes and swelling of mitochondria. Z39Ig+ cells appeared to be useful for identification of resident tissue macrophages in normal synovium and the corresponding macrophages in the synovial lining layer of inflammatory arthritis. Expansion of Z39Ig+CD11c+cells was characteristic of RA synovial lining layer.     

Characteristics of synovial fluid effusion in collagen-induced arthritis (CIA) in the DA rat; a comparison of histology and antibody reactivities in an experimental chronic arthritis model and rheumatoid arthritis (RA)

We have characterized the cellular content and some antibody reactivities in synovial fluid (SF) from DA rats with CIA. Since CIA is widely used as a model for RA, in which many studies concerning immune responses are performed on SF samples, we considered it important to describe the local, disease-causing immune reactions in CIA. At the peak of disease (day 22 after immunization), the major cell population in CIA SF was granulocytes (72%), but macrophages (17.9%), plasma cells (2.6%) and lymphocytes (7.7%) were also present. The CIA synovial membrane (SM) obtained at the same time was mainly infiltrated by monocytes, with granulocytes, lymphocytes and plasma cells also present. Cell populations in blood did not differ between arthritic and normal DA rats. Equally, high anti-collagen type II (CII) and rheumatoid factor (RF) levels could be detected both in SF and in sera. Notably, RF levels were also increased in normal DA rats. Moderate levels of anti-heat shock protein 65 kD (hsp) antibodies were recorded systemically in both normal and diseased animals. In conclusion, the cellular composition in SF and in SM are similar in rat CIA and in RA. The morphological differences between SF and SM that are characteristic for RA could also be demonstrated in CIA. The antibody data indicate systemic production of anti-CII and anti-hsp antibodies as well as RF, but they give no support for local production of these antibodies in the joints, which is the case in RA.     

Secondary and ectopic lymphoid tissue responses in rheumatoid arthritis: from inflammation to autoimmunity and tissue damage/remodeling

Summary: Rheumatoid arthritis is a chronic systemic inflammatory disease primarily affecting the synovium of diarthrodial joints. Despite the currently unknown etiology, overwhelming evidence indicates that both innate and adaptive immunity play a central role in disease pathogenesis. In this review, we consider recent evidence examining the mechanisms of lymphoid tissue reactivity in rheumatoid arthritis with a focus on the dynamics controlling secondary and ectopic lymphoid tissue response. We then examine the cellular and molecular mechanisms regulating the biopathology of these processes with specific emphasis on cell trafficking, contribution to autoimmunity, and joint damage-repair. We finally provide a brief overview of the most recent studies addressing the clinical relevance of synovial lymphoid tissue analysis as a diagnostic and prognostic tool as well as its response to current biological therapies.