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Comparative study of the synovial histology in rheumatoid arthritis, spondyloarthropathy, and osteoarthritis: influence of disease duration and activity

Dominique Baeten UGent, Pieter Demetter, Claude Cuvelier, Filip Van den Bosch UGent, Elli Kruithof, Nancy Van Damme UGent, August Verbruggen UGent, Herman Mielants, Eric Veys and Filip De Keyser UGent (2000) ANNALS OF THE RHEUMATIC DISEASES. 59(12). p.945-953
abstract
Objectives: To compare the macroscopic and microscopic characteristics of synovial tissue in rheumatoid arthritis (RA), spondyloarthropathy (SpA), and osteoarthritis (OA) after exclusion of possible biases induced by disease duration or activity, or both. Methods: Synovial biopsy specimens were obtained by needle arthroscopy in patients with early RA (n=16), late RA (n=14), early SpA (n=23), and OA (n=12). Macroscopic and microscopic features were scored on a four point scale and analysed as a function of disease duration (early versus late RA), local and systemic disease activity, and diagnosis. Results: Except for the maximal synovial lining thickness, no significant differences were seen between early and late RA. For disease activity, synovial histology was only weakly correlated with C reactive protein in RA, but seemed to be strongly dependent on effusion of the biopsied joint in all disease groups. After stratification for local disease activity, no disease related differences were found in patients without joint effusion. In contrast, important differences were found between patients with RA. and SpA with active joint effusion. Synovial vascularity was macroscopically increased in SpA versus RA (p=0.017). A straight vessel pattern was only seen in RA, while tortuous vessels were preferentially seen in SpA. Vascularity was also microscopically increased in SpA compared with RA (p=0.031), and correlated with the macroscopic vascularity (r(s)=0.36, p=0.036). CD3+ (p=0.008), CD4+ (p=0.008), and CD20+ (p=0.024) lymphocytes were overrepresented in RA compared with SpA. The integrin expression in RA. was characterised by a decrease of alphaV beta3 in the synovial lining (p=0.006) and an increase of alphaV beta5 in the sublining (p<0.001). Conclusions: The immune architecture of the synovial membrane is more dependent on local disease activity than on disease duration. Synovium obtained from clinically affected joints shows important histological differences between RA and SpA.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
T-CELLS, MONOCLONAL-ANTIBODY TREATMENT, IMMUNOHISTOLOGICAL FEATURES, ALPHA-V-BETA-3 INTEGRIN, ANKYLOSING-SPONDYLITIS, ADHESION MOLECULES, KNEE JOINTS, EXPRESSION, TISSUE, MEMBRANE
journal title
ANNALS OF THE RHEUMATIC DISEASES
Ann. Rheum. Dis.
volume
59
issue
12
pages
945 - 953
Web of Science type
Article
Web of Science id
000165747900004
ISSN
0003-4967
DOI
10.1136/ard.59.12.945
language
English
UGent publication?
yes
classification
A1
id
128562
handle
http://hdl.handle.net/1854/LU-128562
date created
2004-01-14 13:36:00
date last changed
2016-12-19 15:38:55
@article{128562,
  abstract     = {Objectives: To compare the macroscopic and microscopic characteristics of synovial tissue in rheumatoid arthritis (RA), spondyloarthropathy (SpA), and osteoarthritis (OA) after exclusion of possible biases induced by disease duration or activity, or both. 
Methods: Synovial biopsy specimens were obtained by needle arthroscopy in patients with early RA (n=16), late RA (n=14), early SpA (n=23), and OA (n=12). Macroscopic and microscopic features were scored on a four point scale and analysed as a function of disease duration (early versus late RA), local and systemic disease activity, and diagnosis. 
Results: Except for the maximal synovial lining thickness, no significant differences were seen between early and late RA. For disease activity, synovial histology was only weakly correlated with C reactive protein in RA, but seemed to be strongly dependent on effusion of the biopsied joint in all disease groups. After stratification for local disease activity, no disease related differences were found in patients without joint effusion. In contrast, important differences were found between patients with RA. and SpA with active joint effusion. Synovial vascularity was macroscopically increased in SpA versus RA (p=0.017). A straight vessel pattern was only seen in RA, while tortuous vessels were preferentially seen in SpA. Vascularity was also microscopically increased in SpA compared with RA (p=0.031), and correlated with the macroscopic vascularity (r(s)=0.36, p=0.036). CD3+ (p=0.008), CD4+ (p=0.008), and CD20+ (p=0.024) lymphocytes were overrepresented in RA compared with SpA. The integrin expression in RA. was characterised by a decrease of alphaV beta3 in the synovial lining (p=0.006) and an increase of alphaV beta5 in the sublining (p{\textlangle}0.001). 
Conclusions: The immune architecture of the synovial membrane is more dependent on local disease activity than on disease duration. Synovium obtained from clinically affected joints shows important histological differences between RA and SpA.},
  author       = {Baeten, Dominique and Demetter, Pieter and Cuvelier, Claude and Van den Bosch, Filip and Kruithof, Elli and Van Damme, Nancy and Verbruggen, August and Mielants, Herman and Veys, Eric and De Keyser, Filip},
  issn         = {0003-4967},
  journal      = {ANNALS OF THE RHEUMATIC DISEASES},
  keyword      = {T-CELLS,MONOCLONAL-ANTIBODY TREATMENT,IMMUNOHISTOLOGICAL FEATURES,ALPHA-V-BETA-3 INTEGRIN,ANKYLOSING-SPONDYLITIS,ADHESION MOLECULES,KNEE JOINTS,EXPRESSION,TISSUE,MEMBRANE},
  language     = {eng},
  number       = {12},
  pages        = {945--953},
  title        = {Comparative study of the synovial histology in rheumatoid arthritis, spondyloarthropathy, and osteoarthritis: influence of disease duration and activity},
  url          = {http://dx.doi.org/10.1136/ard.59.12.945},
  volume       = {59},
  year         = {2000},
}

Chicago
Baeten, Dominique, Pieter Demetter, Claude Cuvelier, Filip Van den Bosch, Elli Kruithof, Nancy Van Damme, August Verbruggen, Herman Mielants, Eric Veys, and Filip De Keyser. 2000. “Comparative Study of the Synovial Histology in Rheumatoid Arthritis, Spondyloarthropathy, and Osteoarthritis: Influence of Disease Duration and Activity.” Annals of the Rheumatic Diseases 59 (12): 945–953.
APA
Baeten, D., Demetter, P., Cuvelier, C., Van den Bosch, F., Kruithof, E., Van Damme, N., Verbruggen, A., et al. (2000). Comparative study of the synovial histology in rheumatoid arthritis, spondyloarthropathy, and osteoarthritis: influence of disease duration and activity. ANNALS OF THE RHEUMATIC DISEASES, 59(12), 945–953.
Vancouver
1.
Baeten D, Demetter P, Cuvelier C, Van den Bosch F, Kruithof E, Van Damme N, et al. Comparative study of the synovial histology in rheumatoid arthritis, spondyloarthropathy, and osteoarthritis: influence of disease duration and activity. ANNALS OF THE RHEUMATIC DISEASES. 2000;59(12):945–53.
MLA
Baeten, Dominique, Pieter Demetter, Claude Cuvelier, et al. “Comparative Study of the Synovial Histology in Rheumatoid Arthritis, Spondyloarthropathy, and Osteoarthritis: Influence of Disease Duration and Activity.” ANNALS OF THE RHEUMATIC DISEASES 59.12 (2000): 945–953. Print.