Tak P P, Smeets T J, Daha M R, Kluin P M, Meijers K A, Brand R, Meinders A E, Breedveld F C
Department of Rheumatology, Leiden University Hospital, The Netherlands.
Arthritis Rheum. 1997 Feb;40(2):217-25. doi: 10.1002/art.1780400206.
To define variations in the cellular infiltrate and in the expression of monokines in synovial tissue (ST) from rheumatoid arthritis (RA) patients with different durations of disease and different levels of disease activity.
The immunohistologic features of synovial biopsy specimens from 31 patients with early RA (< 1 year) and 35 patients with longstanding RA (> 5 years) were compared. The possible associations between these features and local disease activity, as measured by the score for pain in the biopsied knee joint were also evaluated.
The immunohistologic features were not dependent on disease duration. We found a positive correlation between the scores for knee pain and the semiquantitative scores for the number of macrophages, as well as the expression of interleukin-6 and tumor necrosis factor alpha, whereas the correlation with the scores for CD4+ T cells was negative. Multivariate analysis showed that these correlations were highly statistically significant (P < 0.003).
The results do not support the view that inflammatory mechanisms in the synovial tissues of RA patients differ between early and late stages of the disease. The findings presented here are consistent with the concept that early RA is the result of a synovitis process of longer duration and that macrophage-derived cytokines play an important role in maintaining the clinical signs of inflammation.
明确不同病程和不同疾病活动水平的类风湿关节炎（RA）患者滑膜组织（ST）中细胞浸润及单核因子表达的差异。
比较31例早期RA（<1年）患者和35例长期RA（>5年）患者滑膜活检标本的免疫组织学特征。还评估了这些特征与通过活检膝关节疼痛评分所衡量的局部疾病活动之间的可能关联。
免疫组织学特征不依赖于病程。我们发现膝关节疼痛评分与巨噬细胞数量的半定量评分以及白细胞介素-6和肿瘤坏死因子α的表达之间呈正相关，而与CD4 + T细胞评分呈负相关。多变量分析表明这些相关性具有高度统计学意义（P <0.003）。
结果不支持RA患者滑膜组织炎症机制在疾病早期和晚期有所不同的观点。此处呈现的研究结果与早期RA是较长病程滑膜炎过程的结果这一概念一致，并且巨噬细胞衍生的细胞因子在维持炎症临床体征中起重要作用。
