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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a case of massive intrapelvic synovial cyst complicating total hip arthroplasty in a 35-year-old woman with rheumatoid arthritis. The clinical presentation raised the possibility of a coincidental soft-tissue malignant tumour. This was ruled out by ultrasonography, computed tomography, fine-needle aspiration with examination of cells and culture and, ultimately, by image intensification in the operating room during aspiration of the cyst and injection of the adjacent hip joint with Hypaque. The authors conclude that perforation of the acetabular floor at total hip arthroplasty was likely the precipitating event. After 1 year there was no indication for surgical excision of the cyst.
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PMID:Massive intrapelvic synovial cyst as a complication of total hip replacement arthroplasty: a case report. 205 59

CD4 expressing T-lymphocytes are involved in the pathogenesis of rheumatoid arthritis, so the possibility of using radiolabelled CD4-specific antibodies to localise diseased joints was studied. Prospectively six patients with rheumatoid arthritis were investigated. Five of them received 200-300 micrograms of a 555 MBq technetium 99m CD4-specific antibody (MAX.16H5) and were examined with three phase bone scans. Max.16H5 (IgG1) was labelled according to the mercaptoethanol (Schwarz) method. Lymphocytes of one patient were isolated on a Ficoll-Hypaque gradient and labelled with the antibody in vitro. Scans were performed 1.5 h, 4 and 24 h post injection in anterior and posterior views. In all patients, diseased joints could be clearly imaged at as early as 1.5 h. The localisation of the diseased joints correlated (P less than 0.01) with the clinical signs, with the early methylene diphosphonate (MDP) scan (P less than 0.01) and only weakly with the late bone scan (P greater than 0.05). According to these data we conclude that 99mTc-labelled CD4-specific antibodies specifically image actively diseased joints in rheumatoid arthritis.
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PMID:Imaging rheumatoid arthritis specifically with technetium 99m CD4-specific (T-helper lymphocytes) antibodies. 214 2

Chemiluminescence (CL) is a simple quantitative assay of polymorphonuclear leucocyte (PMNL) oxidative metabolism. PMNL CL was found to be significantly higher in patients with chronic inflammatory bowel disease than in normal controls (167 +/- 60 vs. 139 +/- 50 mV/10(5) cells, p less than 0.05). There were no significant differences between patients with ulcerative colitis and Crohn's disease. Disease controls with rheumatoid arthritis and with bronchiectasis also demonstrated elevated CL. These results were obtained using a two-step gelatin/Ficoll-Hypaque procedure for PMNL separation. However when PMNLs were prepared using a one-step Ficoll-Hypaque procedure PMNL CL was found to be depressed in chronic inflammatory bowel disease (CIBD). It was demonstrated that this disparity was caused by the elimination of low-density neutrophils with high CL production by the one-step procedure. These data indicate that reports of abnormal in vitro neutrophil function in CIBD should be interpreted with caution since separation techniques which are satisfactory in normal individuals may significantly influence results in patients with inflammatory diseases. Furthermore these data indicate the presence of a subpopulation of activated low-density PMNL in patients with CIBD.
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PMID:Chemiluminescence by polymorphonuclear leucocyte subpopulations in chronic inflammatory bowel disease. Influence of the cell separation procedure. 237 70

Ficoll-Hypaque density gradient preparations of peripheral blood mononuclear cells from patients with systemic lupus erythematosus, rheumatoid arthritis, and acute rheumatic fever were highly "contaminated" with low buoyant density neutrophils. Plasma from these patients could induce an in vitro decrease of buoyancy in neutrophils with normal buoyant density. Similar change could be induced by complement-activated sera and aggregated gamma globulin. These data suggest that activated neutrophils are a common finding in the peripheral blood of these patients and may influence the interpretation of any studies with these cells. Functional studies of lymphocytes separated by Ficoll-Hypaque gradients should also take into account the higher degree of impurity of the cell preparations in patients with rheumatic diseases.
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PMID:Low density neutrophils in patients with systemic lupus erythematosus, rheumatoid arthritis, and acute rheumatic fever. 243 May 86

The chronic inflammatory diseases in humans have been intensively investigated, however the immune mechanisms underlying diseases such as rheumatoid arthritis (RA), inflammatory bowel disease, and periodontal disease (PD) remain elusive. In this study, we have analyzed the distribution of IgM, IgG, and IgA secreting cells with emphasis on the IgG and IgA subclasses among mononuclear cell populations isolated from gingiva at different stages of PD. Surgically removed tissues were treated with Dispase to gently dissociate cells and the Ficoll-Hypaque gradient centrifugation was used to enrich for viable mononuclear cells rich in lymphocytes, macrophages, and plasma cells. The total numbers of plasma cells increased with the severity of disease. Immunofluorescence analysis showed that most Ig-containing cells were of the IgG isotype; however, significant numbers of IgA-positive cells but few IgM-positive cells were seen. This isolation procedure allowed analysis, at the single cell level, of the distribution of IgG and IgA subclasses of antibody-secreting cells with monoclonal antibodies to human IgG and IgA subclasses. For this, we selected four monoclonal anti-IgG subclass (anti-gamma 1, -gamma 2, -gamma 3, and -gamma 4) antibodies with no subclass cross reactivity for use in the enzyme-linked immunospot assay. Analysis of slight, moderate, and advanced stages of PD showed a progressive increase in spotforming cells (SFC) numbers, and the major isotype of SFC was IgG followed by IgA. The major IgG subclass SFC seen was IgG1 followed by IgG2 whereas similar numbers of IgG3 and IgG4 SFC were observed, a pattern also seen with cells from synovium of RA patients and in mitogen-triggered spleen and PBMC. In terms of the IgA subclass distribution, IgA1 predominated in moderate stages, whereas a selective increase in IgA2 SFC were seen in the more advanced stage of PD. These results show that significant numbers of viable plasma cells/Ig-secreting cells can be isolated from inflamed gingival tissues. Further, careful analysis has shown that IgG subclass responses in gingiva are similar to those found in synovia of RA subjects, and in stimulated PBMC and spleen. However, it should be noted that the number of IgG4- and IgA2-secreting cells increased in the advanced stage of PD.
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PMID:Analysis of human IgG and IgA subclass antibody-secreting cells from localized chronic inflammatory tissue. 264 50

We have been interested in contributions of certain cells and mediators to synovial inflammation rheumatoid arthritis (RA). The present studies were designed to determine (1) whether monocytes contained the neutral proteinase cathepsin G and (2) if neutral proteinase could induce or potentiate cellular IgM rheumatoid factor (RF) production. Monocyte-rich and monocyte-poor populations were isolated by Ficoll-Hypaque density sedimentation followed by glass adherence, and cellular lysates were obtained by repetitive freezing and thawing as we have reported for neutrophil-derived neutral proteinase. Cathepsin G was quantified immunochemically by an enzyme-linked immunoassay (ELISA) we developed utilizing commercially available anti-cathepsin G antibodies. Mononuclear and B-cell-enriched cell cultures were prepared by standard methods and IgM RF measured by our ELISA. Cell-derived lysates from monocyte-enriched populations (84 +/- 3% monocytes, less than 1% neutrophils) contained considerably greater amounts of measurable cathepsin G (OD280 = 0.393 +/- 0.153) than lysates from equal numbers of monocyte (15 +/- 2% monocytes, less than 1% neutrophils)-depleted cells (OD280 = 0.071 +/- 0.038; P less than 0.05). Eighteen patients with RA and three normal individuals did not have consistently increased cellular elaboration of Ig or IgM RF in vitro in response to proteinase (trypsin) stimulation; however, patients manifested 80% potentiation by trypsin of pokeweed-stimulated cellular IgM RF production in vitro (pokeweed-stimulated IgM RF 137 +/- 53 ng/ml, pokeweed/trypsin-induced IgM RF 246 +/- 100 ng/ml; P less than 0.02), changes being most striking for those patients seropositive by latex fixation test (84% increase, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human mononuclear cells and neutral proteinases. III. Neutral proteinases and rheumatoid arthritis: monocytes as a source of cathepsin G and proteinase potentiation of IgM rheumatoid factor elaboration. 275 24

Peripheral blood polymorphonuclear leucocytes (PMNs) were isolated from six normal individuals and from 27 patients with rheumatoid arthritis (RA) by the Ficoll-Hypaque rapid single step centrifugation technique, fixed in suspension, and examined by scanning electron microscopy (SEM). In addition, four of the preparations from normal individuals and eight from patients with RA were examined by transmission electron microscopy (TEM). Most PMNs in preparations from normal subjects were spherical, unpolarised, and had their surface membrane elaborated into irregular ridges and small ruffles; they contained few phagocytic vacuoles and large numbers of electron dense primary and secondary granules. A minority of the cells were non-spherical, polarised, and had portions of their surface membrane elaborated into ruffled pseudopodia. In contrast, preparations of RA PMNs frequently contained fewer unpolarised PMNs and a higher number of polarised PMNs than did preparations of normal PMNs. Some preparations of RA PMNs also contained substantial numbers of spherical cells whose surface was covered mainly by bulges and blebs. Concurrent examination by TEM showed that RA PMNs frequently contained more phagocytic vacuoles and fewer electron dense primary and secondary granules than normal PMNs. The morphological and ultrastructural changes seen in RA PMNs resembled those which normal PMNs are known to undergo on exposure to C5a in vitro, during adherence to endothelial cells in vivo, or during phagocytosis in vivo or in vitro. Our observations, therefore, provide a useful morphological correlation to those in vitro studies in which differences in the functional activity of RA and normal PMNs have been shown. The possibility that the difference seen between RA and normal PMNs is artefactual and does not represent the genuine in vivo states of these cells is discussed.
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PMID:Scanning electron microscopy of rheumatoid arthritis peripheral blood polymorphonuclear leucocytes. 378 25

We reported that rheumatoid arthritis (RA) blood mononuclear cells (MNC) secreted less Ig and IgM rheumatoid factor (RF) than synovial cells. Since antibody elaboration is partly monocyte dependent, we compared regulatory, effector, and phenotypic properties of monocytes from 31 patients with RA with those of 21 normal subjects. RA IgG and IgM elaboration was less than normal. Monocyte, T or B cell numbers were comparable in RA and normal MNC and monocyte enriched/depleted preparations. RA and normal Ig production were monocyte dependent and this differed for IgG and IgM for RA and normals. IgM RF elaboration by stimulated RA MNC was also monocyte dependent and addition of normal monocytes/monocyte culture supernatants to RA monocyte depleted cultures and vice versa had inconsistent effects. RA MNC (Ficoll-Hypaque) phagocytosis was less than normal; killing (acridine orange fluorescent microscopy) was not. RA synovial monocyte phagocytosis - but not killing was also reduced. MNC from RA patients and normals contained similar numbers of monocytes; RA monocyte enriched populations (Percoll) showed less phagocytosis than normal; with similar killing. RA phagocytosis was reduced at 1,2,3,4 and 5 h and differed from normal at 3 and 5 h. Different sera - FCS, autologous, normal, RA - exhibited inconsistent effects on phagocytosis. RA and normal neutrophil phagocytosis and killing were comparable. Lastly, RA monocyte enriched preparations contained populations of OKM1, OKM3, OKM5, OKM6, Leu M1, Leu M2, Leu M3, and HLA-DR-positive cells (FACS analysis) comparable with normals. Regulatory and effector but not phenotypic properties of RA blood monocytes differed from normal and may contribute to inappropriate autoantibody production and chronic inflammation.
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PMID:Monocytes in rheumatoid arthritis. Regulatory, effector, and phenotypic properties. 409 12

Attempts to use the rapid single-step Ficoll-Hypaque centrifugation procedure for the purification of mononuclear and polymorphonuclear leucocytes from the blood of normal individuals and rheumatoid arthritis patients have sometimes been unsuccessful, largely because the erythrocytes would not sediment through the centrifugation medium. Re-evaluation of the factors (e.g. Ficoll concentration, temperature, and ratio of the diatrizoate salts) which affect these separations showed that under our conditions it was advantageous to use a medium with a lower viscosity (Ficoll concentration) and/or a higher osmotic strength (increased sodium diatrizoate: meglumine diatrizoate) than had been recommended previously (Ferrante and Thong, 1978; 1980; Ferrante et al., 1982). Higher osmotic strength media must be used for separating the components of blood from rheumatoid arthritis patients than from normal individuals because rheumatoid arthritis erythrocytes have a lower buoyant density than normal erythrocytes.
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PMID:Centrifugation of normal and rheumatoid arthritis blood on Ficoll-Hypaque and Ficoll-Nycodenz solutions. 649 10

In-vitro synthesis of peripheral blood lymphocytes from patients with rheumatoid arthritis was measured after stimulation with phytohaemagglutinin (PHA) in a short-term, serum-free culture system. Diminished responses were found in 16 out of 17 consecutive patients with active disease. Normal PHA responsiveness was recovered by assaying Ficoll-Hypaque isolated E rosette forming cells in serum-free medium, indicating basically normal T cell function in RA. Preincubation of normal peripheral blood lymphocytes (or isolated E rosette forming cells) with sera obtained from patients with active RA for 30 minutes at 4 degrees C or 37 degrees C blocked PHA responsiveness in 34 out of 43 tests. This suggests that serum blocking factors may be responsible for reduced T cell reactivity in RA.
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PMID:In-vitro T cell mediated function in patients with active rheumatoid arthritis. 697 May 51


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