Pachowsky Milena L, Raimondo Maria Gabriella, Xu Cong, Rauber Simon, Tascilar Koray, Labinsky Hannah, Vogg Mario, Aziz Saad Mina Saad, Simon David, Rech Juergen, Soare Alina, Braeuer Lars, Kleyer Arnd, Schett Georg, Ramming Andreas
Department of Internal Medicine 3, Rheumatology & Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Bayern, Germany.
Deutsches Zentrum Immuntherapie, Friedrich-Alexander-University (FAU) Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
Ann Rheum Dis. 2022 Aug;81(8):1131-1135. doi: 10.1136/annrheumdis-2021-222061. Epub 2022 Apr 22.
To establish a minimally invasive biopsy technique for the analysis of entheseal tissue in patients with psoriatic arthritis (PsA).
Human cadavers were used for establishing the technique to retrieve tissue from the lateral humeral epicondyle enthesis (cadaveric biopsies). After biopsy, the entire enthesis was surgically resected (cadaveric resections). Biopsies and resections were assessed by label-free second harmonic generation (SHG) microscopy. The same technique was then applied in patients with PsA with definition of entheseal tissue by SHG, staining of CD45+immune cells and RNA extraction.
Entheseal biopsies from five cadavers allowed the retrieval of entheseal tissue as validated by the analysis of resection material. Microscopy of biopsy and resection sections allowed differentiation of entheseal, tendon and muscle tissue by SHG and definition of specific intensity thresholds for entheseal tissue. In subsequent entheseal biopsies of 10 PsA patients: the fraction of entheseal tissue was high (65%) and comparable to cadaveric biopsies (68%) as assessed by SHG microscopy. Furthermore, PsA biopsies showed immune cell infiltration and sufficient retrieval of RNA for further molecular analysis.
Entheseal biopsy of the lateral epicondyle is feasible in patients with PsA allowing reliable retrieval of entheseal tissue and its identification by SHG microscopy.
建立一种微创活检技术，用于分析银屑病关节炎（PsA）患者的附着点组织。
使用人体尸体建立从肱骨外侧髁附着点获取组织的技术（尸体活检）。活检后，通过手术切除整个附着点（尸体切除）。活检和切除组织通过无标记二次谐波产生（SHG）显微镜进行评估。然后将相同技术应用于PsA患者，通过SHG定义附着点组织，对CD45 +免疫细胞进行染色并提取RNA。
五具尸体的附着点活检能够获取附着点组织，切除材料分析验证了这一点。活检和切除切片的显微镜检查通过SHG可区分附着点、肌腱和肌肉组织，并确定附着点组织的特定强度阈值。在随后对10例PsA患者进行的附着点活检中：通过SHG显微镜评估，附着点组织的比例较高（65%），与尸体活检（68%）相当。此外，PsA活检显示有免疫细胞浸润，并且能够充分获取RNA用于进一步的分子分析。
PsA患者的外侧髁附着点活检是可行的，能够可靠地获取附着点组织并通过SHG显微镜进行识别。
