Rheumatology, Vol 38, 431-440, Copyright © 1999 by British Society for Rheumatology
A Ceponis, J Hietanen, M Tamulaitiene, G Partsch, H Patiala and YT Konttinen
OBJECTIVES: Inflammatory arthritides/synovitides such as psoriatic (PsA),
reactive (ReA) and rheumatoid (RA) arthritis share numerous
immunopathological features, but develop different patterns of joint
involvement. To investigate whether distinctive cell apoptosis may play a
role in this context, we have assessed synovial cell apoptosis in situ in
PsA and ReA, and compared it with RA and 'non-inflammatory' controls.
METHODS: TdT-mediated dUTP nick end-labelling (TUNEL) of DNA breaks
complemented immunoperoxidase staining for CD68 or LCA as the specific cell
markers. RESULTS: The proportion of apoptotic synovial lining cells was
high in PsA, ReA and RA compared to values in controls (P < 0.05). No
differences existed between these inflammatory arthritides in numbers or
type of apoptotic lining cells. In RA, however, in contrast to PsA and ReA,
apoptotic lining cells were clustered or, in a small subset of samples,
were very low in number. Prominent apoptosis of inflammatory cells in the
sublining in ReA has accounted for higher overall apoptotic cell numbers in
synovial stroma (sublining + perivascular inflammatory cell infiltrates) in
this condition than in RA or PsA (P < 0.05). CONCLUSIONS: No disease-
specific pattern in the phenotype of apoptotic synovial lining cells could
be suggested in any of the inflammatory arthritides studied. However,
topological differences in the lining and quantitative differences in the
inflammatory cell apoptosis in synovial stroma may in part explain the
occurrence of the prominent synovial lining cell hyperplasia distinguishing
RA from ReA and PsA. On the other hand, relatively frequent inflammatory
cell apoptosis may contribute both to the downregulation of synovial
inflammation and to the control of synovial lining hyperplasia in ReA.
ORIGINAL PAPERS
A comparative quantitative morphometric study of cell apoptosis in synovial membranes in psoriatic, reactive and rheumatoid arthritis
Department of Anatomy, Institute of Biomedicine, University of Helsinki, Helsinki University Central Hospital, Invalid Foundation, Finland.
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