Menninger H, Lambusch M, Mohr W, Wessinghage D
Z Rheumatol. 1983 Jan-Feb;42(1):7-15.
Previous reports describe the presence of immunoglobulins and complement components within rheumatoid articular cartilage, thereby suggesting an effect of immune complexes on the formation of pannus. This hypothesis is reinvestigated in this paper. As confirmed in our work, the superficial layer of rheumatoid hyaline cartilage may fulfill the immunohistological criteria for the presence of immune complexes. In osteoarthritis, however, a noninflammatory disease not mediated by immunologic mechanisms, similar results can be obtained. The presence of immune-proteins within hyaline cartilage therefore requires a cautious interpretation. Hyaline cartilage in rheumatoid arthritis is replaced by granulation tissue growing not only at its surface (pannus), but also in subchondral bone. We therefore also thoroughly investigated deep layers of hyaline cartilage in the vicinity of such subchondral tissue, but could not obtain any evidence for the presence of immune complexes therein. The growth of subchondral granulation tissue and the accumulation of PMN in the region of its junction with hyaline cartilage therefore appear to be independent of immune complexes within rheumatoid hyaline cartilage. It is suggested on the basis of these data that immune complexes possibly present in hyaline cartilage do not play an essential role in the formation of granulation tissue replacing cartilage in rheumatoid arthritis. It is, however, not entirely excluded that during advanced stages of rheumatic cartilage degradation immune complexes are formed within the matrix or carried into it from the extra-cartilaginous environment, and that they may then contribute to further cartilage destruction by enzyme release during phagocytic processes.
先前的报告描述了类风湿性关节软骨中存在免疫球蛋白和补体成分，从而提示免疫复合物对血管翳形成的影响。本文对这一假说进行了重新研究。正如我们的工作所证实的，类风湿性透明软骨的表层可能符合免疫复合物存在的免疫组织学标准。然而，在骨关节炎这种不由免疫机制介导的非炎症性疾病中，也能得到类似的结果。因此，透明软骨中免疫蛋白的存在需要谨慎解读。类风湿性关节炎中的透明软骨被不仅在其表面生长（血管翳）而且在软骨下骨中生长的肉芽组织所取代。因此，我们还彻底研究了这种软骨下组织附近透明软骨的深层，但未获得其中存在免疫复合物的任何证据。因此，软骨下肉芽组织的生长以及其与透明软骨交界处PMN的积聚似乎与类风湿性透明软骨中的免疫复合物无关。基于这些数据表明，透明软骨中可能存在的免疫复合物在类风湿性关节炎中取代软骨的肉芽组织形成过程中并不起关键作用。然而，也不能完全排除在风湿性软骨降解的晚期，免疫复合物在基质中形成或从软骨外环境带入其中，然后它们可能在吞噬过程中通过酶释放导致进一步的软骨破坏。
