SYNOVIAL MEMBRANE CHANGES IN PATIENTS WITH RHEUMATOID ARTHRITIS REVEALED DURING ARTHROSCOPY
https://doi.org/10.14412/1995-4484-2017-241-244
Abstract
Exudative or proliferative processes accompanied by joint destruction may predominate in the synovial membrane (SM) in different stages of rheumatoid arthritis (RA). The features of SM changes should be considered in the early diagnosis of RA and in the development of combination treatment for this disease.
Objective: to study arthroscopic SM changes in patients with different RA durations and different blood anti-cyclic citrullinated peptide (anti-CCP) antibody levels.
Subjects and methods. 37 patients with RA underwent arthroscopy with an arthroscope of a 2.4-mm diameter and 30° angle (Karl Storz GmbH, Germany). RA duration was <2 years in 17 patients and ranged from 2 to 8 years in 20; the blood level of anti-CCP antibodies did not exceed 60 IU/ml in 15 patients and it was higher in 22. SM changes were assessed by a semiquantitative method.
Results and discussion. Arthroscopy revealed a preponderance of SM hyperemia with an increased vascular pattern (p<0.01) and fibrin deposits (p<0.05) in patients with a RA duration of < 2 years and that of villous hyperplasia with the formation of club-shaped villi (p<0.05) in those with a RA duration of >2 years. The increase in anti-CCP by >60 U/ml was associated with a predominance of inflammatory hyperplasia (p < 0.01), SM hyperemia with a pronounced vascular pattern (p<0.05), as well as with the presence of pannus (pp<0.01).
About the Author
E. B. Komarova
Lugansk State Medical University, Lugansk
Russian Federation
Russian Federation
1g, 50 Years of Lugansk Defense Quarter, Lugansk 91045
References
1. Dhaouadi T, Sfar I, Abelmoula L, et al. Role of immune system, apoptosis and angiogenesis in pathogenesis of rheumatoid arthritis and joint destruction, a systematic review. Tunis Med. 2007;85(12):991-8.
2. Hitchon CA, El-Gabalawy HS. The synovium in rheumatoid arthritis. Open Rheumatol J. 2011;5:107-14. doi: 10.2174/1874312901105010107
3. Лялина ВВ, Шехтер АБ. Артроскопия и морфология синовитов. Москва: Наука; 2007. 108 с. [Ljalina VV, Shehter AB. Artroskopiya i morfologiya sinovitov [Arthroscopy and morphology of sinovitis]. Moscow: Nauka; 2007. 108 p.].
4. Klint E, Catrina AI, Matt P, et al. Evaluation of arthroscopy and macroscopic scoring. Arthr Res Ther. 2009;11:R81. doi: 10.1186/ar2714
5. Carl HD, Swoboda B. Effectiveness of arthroscopic synovectomy in rheumatoid arthritis. Rheumatology. 2008;67(6):485-90.
6. Capitanescu B, Simionescu C, Margaritescu C, et al. Сlinical and morphological aspects of sinovitis in early rheumatoid arthritis. Curr Health Sci J. 2011;37(1):17-20.
7. Vordenbä umen S, Sewerin P, Lö gters T, et al. Inflammation and vascularisation markers of arthroscopically-guided finger joint synovial biospies reflect global disease activity in rheumatoid arthritis. Clin Exp Rheumatol. 2014 Jan-Feb;32(1):117-20.
8. Machold KP. Very recent onset rheumatoid arthritis: clinical and serological patient characteristics associated with radiographic progression over the first years of disease. Rheumatology (Oxford). 2007;46:342-9. doi: 10.1093/rheumatology/kel237
9. Algergawy SA, Abd El-Sabour M, Osman AS, et al. Early diagnostic and prognostic values of anti-cyclic citrullinated peptide antibody and cartilage oligomeric matrix protein in rheumatoid arthritis. Egypt J Immunol. 2013;20(2):11-20.
10. Лучихина ЛВ, Каратеев ДЕ. Новые подходы к ранней диагностике артроза и перспективы его патогенетической терапии. Современная ревматология. 2014;8(4):33-8 [Luchikhina LV, Karateev DE. New approaches to early diagnosis of arthrosis and prospects for its pathogenetic therapy. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2014;8(4):33-8 (In Russ.)]. doi: 10.14412/1996-7012-2014-4-33-38
11. Paleolog EM. The vasculature in rheumatoid arthritis: cause or consequence? Int J Exp Pathol. 2009;90(3):249-61. doi: 10.1111/j.1365-2613.2009.00640.x
12. Marrelli A, Cipriani P, Liakouli V, et al. Angiogenesis in rheumatoid arthritis: a disease specific process or a common response to chronic inflammation? Autoimmun Rev. 2011;10(10):595-8. doi: 10.1016/j.autrev.2011.04.020
13. Clavel G, Bessis N, Lemeiter D, et al. Angiogenesis markers (VEGF, soluble receptor of VEGF and angiopoietin-1) in very early arthritis and their association with inflammation and joint destruction. Clin Immunol. 2007;124(2):158-64. doi: 10.1016/j.clim.2007.04.014
14. Раденска-Лоповок СГ. Ревматические заболевания. Морфологическая диагностика: Руководство для врачей. Москва: Практическая медицина; 2014. С. 13 [Radenska-Lopovok SG. Revmaticheskie zabolevaniya. Morfologicheskaya diagnostika: Rukovodstvo dlya vrachey [Rheumatic diseases. Morphological diagnostics: A guide for doctors]. Moscow: Prakticheskaya Meditsina; 2014. Р.13].
15. Van Oosterhout M, Bajema I, Levarht EW, et al. Differences in synovial tissue infiltrates between anti-cyclic citrullinated peptidepositive rheumatoid arthritis and anti-cyclic citrullinated peptidenegative rheumatoid arthritis. Arthritis Rheum. 2008 Jan;58(1):53- 60. doi: 10.1002/art.23148
16. Boyesen P, Hoff M, Odegard S, et al. Antibodies to cyclic citrullinated protein and erythrocyte sedimentation rate predict hand bone loss in patients with rheumatoid arthritis of short duration: a longitudinal study. Arthritis Res Ther. 2009;11(4):R103. doi: 10.1186/ar2749
17. Демидова НВ. Взаимосвязь иммуногенетических и иммунологических маркеров и их влияние на активность заболевания и рентгенологическое прогрессирование у больных ранним ревматоидным артритом. Научно-практическая ревматология. 2009;47(3):12-7 [Demidova NV. Relationship of immunogenetic and immunologic markers and their influence on disease activity and radiological progression in patients with early rheumatoid arthritis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2009;47(3):12-7 (In Russ.)]. doi: 10.14412/1995-4484-2009-1307
Review
For citations:
Komarova E.B. SYNOVIAL MEMBRANE CHANGES IN PATIENTS WITH RHEUMATOID ARTHRITIS REVEALED DURING ARTHROSCOPY. Rheumatology Science and Practice. 2017;55(3):241-244. (In Russ.) https://doi.org/10.14412/1995-4484-2017-241-244
Views:
1507
Email this article 