Stromal cell activity in bone marrow from the tibia and iliac crest of patients with rheumatoid arthritis.

Bone marrow aspirates were obtained from the iliac crest and tibial epiphysis in 23 patients with rheumatoid arthritis (RA) who were undergoing total knee arthroplasty. The number of fibroblast colony-forming units (CFU-F), which contain osteogenic precursor cells, and alkaline phosphatase (ALP) activity, as a marker of the osteoblastic phenotype. were compared between the iliac and tibial marrow for each patient. The prevalence of CFU-F in tibial marrow was similar to that in iliac marrow (96% vs 100%, respectively). However, the average number of CFU-F per 4 x 10(5) bone marrow mononuclear cells was significantly lower in tibial marrow than in iliac marrow (8.2 vs 28.1, respectively; P < 0.01). Although ALP activity was detected in all iliac and tibial marrow specimens, it was significantly lower in tibial marrow compared with iliac marrow (3.7 vs 11.9 nmol/min/mg protein, respectively; P < 0.01). In addition, there was a significant correlation between the patient's age and the number of CFU-F in iliac marrow (r = -0.547; P < 0.01), although there was no correlation in tibial marrow. These results demonstrate that the osteogenic activity of bone marrow varies at different sites in patients with RA. The data may also contribute to further investigation into the differential effects of various disease processes on systemic as well as local stromal cell activity in bone marrow.