甲型肝炎患者淋巴细胞mIL－2R的表达及血清sIL－2R释放的动态变化

对５２例甲型肝炎（甲肝）患者血ＴＩＬ－２Ｒ释放水平进行了动态观察，并对患者ＰＢＭＣｍＩＬ－２Ｒ的表达进行了同步监测。发现在甲肝急性期，ｍＩＬ－２Ｒ的表达（２０．５５±１０．５２％）及ｓＩＬ－２Ｒ的释放（６６４．１３±４８８．８４ｕ／ＭＬ）均较正常对照组（７．５５±４．２８％，Ｐ＜０．００１；１８８．９０±１２２．９１ｕ／ｍＬ，Ｐ＜０．００１）显著增强，恢复期（９．３２±６．２０％；２０６．７８±１７６．０７ｕ／ＭＬ）两者均基本降至正常水平。相关分析发现ｍＩＬ－２Ｒ的表达与ｓＩＬ－２Ｒ的释放存在显著的正相关，两者与ＡＬＴ之间亦显著相关。提示ｍＩＬ－２Ｒ的表达及ｓＩＬ－２Ｒ的释放可能与甲肝患者的肝损伤有关。     

INTERLEUKIN-2 SECRETION BY SYNOVIAL FLUID LYMPHOCYTES IN RHEUMATOID ARTHRITIS

Interlcukin-2 (IL-2) receptor bearing cells and soluble IL-2,measured in a bioassay with IL-2 dependent human T-cell blasts,were recognized in synovial fluid, but not in the peripheralblood of patients with rheumatoid arthritis (RA). After stimulationin vitro with appropriate concentrations of the mitogen concanavalinA (Con-A), comparable proportions of IL-2 receptor (IL-2R) bearingcells were seen in cultures of synovial fluid lymphocytes (SFL)and in cultures of peripheral blood lymphocytes (PBL). On theother hand, higher levels of secreted IL-2 were found in SFLcultures compared to corresponding PBL cultures of RA patientsand normal donors. Specificity of the IL-2 bioassay was confirmed by blocking theT-cell blast proliferation (induced by SFL culture supernatants),by 83±4%, after addition of a monoclonal anti-IL-2R antibody.Despite the high levels of soluble IL-2, only a weak proliferativeresponse was observed in the corresponding SFL cultures. KEY WORDS: Cytokines, Reactive arthritis, Lymphocyte prohferation, Mitogen stimulation, Inhibition     

FIBRINOLYTIC ACTIVITY IN THE SYNOVIAL MEMBRANE OF OSTEOARTHRITIS

The fibrinolytic activity (FA) has been studied on the synovialmembrane obtained from 16 patients with osteoarthritis (OA),20 patients with rheumatoid arthritis (RA) and 11 control subjects.Todd's autohistographic method, modified by Lotti, was usedto investigate the FA and the monoclonal antibodies againstu-PA and t-PA were used to identify the main plasminogen activator. Our results show that the FA is increased in the synovial membraneof patients with OA in comparison with the synovial FA of controlsubjects. In the synovial membranes from patients with RA, theFA shows different results: in some specimens FA is increased,and in others it is diminished or similar, compared with FAof samples from healthy controls. Thus, our data on synovialFA in OA confirm the previous reports, performed in vitro, onthe activation of the plasmin system in this degenerative disease.The activity of the fibrinolytic system seems to participatein the cartilage degeneration and, via the activation of collagenase,to perpetuate the cartilage damage. KEY WORDS: Fibrinolysis, Plasminogen activators, Osteoarthritis, Rheumatoid arthritis, Synovial membrane     

T-CELL CLONALITY IN SYNOVIAL FLUID FROM RHEUMATOID JOINTS BEFORE AND AFTER CULTURE IN INTERLEUKIN-2

T-cell receptor (TCR) gene rearrangements which have been amplifiedin polymerase chain reactions (PCRs) and analysed by high resolutionpolyacrylamide gel electrophoresis have been used to investigatethe clonal diversity of T-cells in joint effusions from 16 patientswith rheumatoid arthritis, one with systemic lupus erythematosusand one with psoriatic arthropathy. Polyclonality was foundin every case but an oligoclonal subset of dominant rearrangementswas also demonstrated in all but the patient with psoriasis.Marked changes in the relative preponderance of the variousclonotypes wer observed in 29 of 48 paired tests from 12 casesbefore and after culture in media containing interleukin-2 (IL-2)showing that SF mononuclear cells cultured in vitro with IL-2are not representative of those present in vivo. KEY WORDS: T-cell receptor gene rearrangements, T-cell clonal dominance, Rheumatoid arthritis, Systemic lupus erythematosus, Psoriatic arthropathy     

LOCALIZATION OF INTERLEUKIN-1{alpha}, TYPE 1 INTERLEUKIN-1 RECEPTOR AND INTERLEUKIN-1 RECEPTOR ANTAGONIST IN THE SYNOVIAL MEMBRANE AND CARTILAGE/PANNUS JUNCTION IN RHEUMATOID ARTHRITIS

Using monoclonal antibodies and immunohistochemical techniqueswe have investigated the presence and distribution of interleukin-1     

ULTRASTRUCTURE OF THE MOUSE SYNOVIAL MEMBRANE

The synovial membrane of the mouse knee joint was examined by electron microscopy and electron microscopic histochemistry, with special reference to the development of the extracellular matrix. In the embryonic synovium, the intercellular spaces were filled with hyaluronate and chondroitin sulfate. The formation of the early joint cavity appeared to be initiated by accumulation of hyaluronate and chondroitin sulfate in the synovial primordium. At the postnatal stage, the synovial primordium differentiated into a true synovial intima that could be easily identified by the presence of two distinct lining cells: fibroblast-like cells (B cells) and phagocytic cells (A cells). Simultaneously, the synovial intima provided the specialized extracellular matrix that was characterized by organized structures of micro-fibrils, collagen fibers, and fibrous long spacing fibers embedded in a large number of glycoproteins.     

DIAGNOSTIC USE OF IMMUNOGLOBULIN AND T-CELL RECEPTOR GENE REARRANGEMENTS IN LYMPHOPROLIFERATIVE DISEASE

Gene rearrangements of immunoglobulin and T cell antigen receptor gene loci were studied in 67 patients referred to a general hematology clinic. The results of gene analysis supported the clinical diagnosis in most cases where involved tissue was studied. However, in a number of cases, gene rearrangement studies gave unexpected results of possible diagnostic significance. Thus two patients who presented diagnostic difficulties were finally diagnosed as having non-Hodgkin's lymphoma; gene analysis suggested that the initial diagnosis of Hodgkin's disease may have been correct. In two patients who had chronic lymphocytosis and were suspected of having chronic lymphocytic leukemia, no evidence of monoclonal disease of B or T cells could be found and the basis for the lymphocytosis was presumed to be non-malignant. Gene analysis was able to detect monoclonal B cell disease in the otherwise normal blood of two of six patients with lymphoma, one of two patients with macroglobulinemia, and none of six patients with myeloma.
The study of gene rearrangements may be a practical aid to diagnosis in some situations of uncertainty.     

INCREASED EXPRESSION OF INTERFERON (IFN)-GAMMA TOGETHER WITH IFN-GAMMA RECEPTOR IN THE RHEUMATOID SYNOVIAL MEMBRANE COMPARED WITH SYNOVIUM OF PATIENTS WITH OSTEOARTHRITIS

Data concerning the presence of T-cell-derived cytokines inthe rheumatic joint are conflicting, challenging, the hypothesisthat rheumatoid arthritis (RA) is a T-cell-mediated disease.In this study synovial tissue specimens of 11 patients withRA and eight patients with osteoarthritis (OA) were stainedfor interferon-gamma (IFN-     

TSH RECEPTOR ANTIBODY SYNTHESIS BY THYROID LYMPHOCYTES

Several indirect observations have indicated that lymphocyte in the thyroid may be an important site of TSH receptor antibody synthesis in Graves' disease and we now describe an investigation of this possibility using improved lymphocyte isolation and TSH receptor antibody assay procedures. Our studies demonstrate that thyroid lymphocytes spontaneously produce TSH receptor antibody in culture. Furthermore, experiments with mitogen tend to suggest that these cells, in contrast to lymphocytes from lymph nodes draining the thyroid, are part of an active immune response to the TSH receptor.     

QUANTITATIVE ASSESSMENT OF THE SYNOVIAL MEMBRANE IN THE RHEUMATOID WRIST: AN EASILY OBTAINED MRI SCORE REFLECTS THE SYNOVIAL VOLUME

Determination of the synovial membrane volume in the rheumatoidarthritis (RA) wrist by gadolinium-DTPA-enhanced MRI is introduced.Moreover, dynamic imaging and an MRI score of synovial hypertrophy,based on gradings in six regions, are evaluated as substitutesof the time-consuming volume calculations. Twenty-six RA wristswere examined. Synovial membrane volumes ranged from 1 to 20ml (median 9 ml). Synovial hypertrophy scores were highly correlatedto synovial volumes (Spearman r = 0.88; P < 10^–1 foruncorrelated values). The volumes and scores were significantlyhigher in wrists with joint swelling and/or joint tendernessthan in wrists without these signs (Mann-Whitney, both P <0.05). Suboptimal slice selection made dynamic imaging uninformative.MRI allows quantification of the synovial volume in the rheumatoidwrist. The volume is related to clinical signs of inflammation,but may also give information about the cumulated synovial proliferationin the joint. An easily obtained score of synovial hypertrophyreflects the synovial volume and may thus be a useful markerof synovial involvement. KEY WORDS: Rheumatoid arthritis, Synovitis, Arthritis, Magnetic resonance imaging, Nuclear magnetic resonance, Gadolinium, Gadopentetate dimeglumine, Wrist     

WISKOTT-ALDRICH SYNDROME IN IDENTICAL TWINS: ABNORMALITY OF CD4 AND CD8 POSITIVE LYMPHOCYTES

The rare occurrence of Wiskott-Aldrich syndrome (WAS) in identical twin brothers without a preceding family history of the disease is described. Investigation into the nature of the lymphocyte abnormality in the surviving twin suggests that the frequency of T cell clone forming cells is markedly decreased. Further analysis of the T cell clones showed a deficiency of CD8 positive cytotoxic/suppressor cells. This alteration may be an underlying mechanism in the development of some of the clinical manifestations of WAS     

LACTOFERRIN IN SYNOVIAL FLUID

The synovial lactoferrin (LF) concentrations of 59 patientswith active rheumatoid arthritis were determined. The medianvalue of LF was 4.64±3.59 mg/100 ml, but in degenerativearthropathy the levels of the metal-protein were much lowerand often not titratable. These variations in the LF concentration explain the low blood-ironlevels in inflammatory states, even when the concentration ofthe metal-protein is not statistically correlated in inflammatorytests, IgG, complement fractions (of the normal or alternatepathway), or variations of other protein fractions of leucocyteorigin.     

SYNOVIAL INVOLVEMENT IN HODGKIN'S DISEASE

We report a case of monoarthropathy in a patient with Hodgkin'sdisease, due to invasion of the synovium, with apparently normaljuxta-articular bone.