OBJECTIVE: Juvenile idiopathic arthritis (JIA) consists of a heterogeneous group of inflammatory disorders, within which there are a number of clinical subgroups. Diagnosis and assignment to a particular subgroup can be problematical and more concise methods of subgroup classification are required. This study of the synovial membrane characterises the immunohistochemical features in early untreated, newly diagnosed JIA and compares findings with disease subgroup at 2 years. METHODS: 42 patients with newly diagnosed untreated JIA underwent synovial biopsy before the administration of steroids or disease-modifying antirheumatic drugs. Patients were classified as either polyarticular, persistent oligoarticular or extended-to-be oligoarticular. The location and semiquantitative analysis of T-cell subsets, B cells, macrophages and blood vessels were determined using immunohistochemistry. RESULTS: Synovial hyperplasia varied significantly between the three groups (p<0.0001). There was a significant difference in the CD3 T-cell population between the three groups (p=0.004) and between the extended-to-be and persistent group (p=0.032). CD4 expression was significantly higher in the poly and extended-to-be oligo groups (p=0.002), again the extended-to-be group had more CD4 T cells than the persistent group (p=0.008). B-cell infiltrates were more marked in the polyarticular group and were significantly higher in the extended-to-be group compared with the persistent group (p=0.005). Vascularisation was more pronounced in the polyarticular and extended-to-be oligoarticular groups, the extended-to-be group had significantly more vascularisation than the persistent group (p=0.0002). CONCLUSIONS: There are significant differences in the histomorphometric features of synovial tissue between patient subgroups. Immunohistological examination of synovial membrane biopsies may provide further insight into early disease processes in JIA.
OBJECTIVE: Juvenile idiopathic arthritis (JIA) consists of a heterogeneous group of inflammatory disorders, within which there are a number of clinical subgroups. Diagnosis and assignment to a particular subgroup can be problematical and more concise methods of subgroup classification are required. This study of the synovial membrane characterises the immunohistochemical features in early untreated, newly diagnosed JIA and compares findings with disease subgroup at 2 years. METHODS: 42 patients with newly diagnosed untreated JIA underwent synovial biopsy before the administration of steroids or disease-modifying antirheumatic drugs. Patients were classified as either polyarticular, persistent oligoarticular or extended-to-be oligoarticular. The location and semiquantitative analysis of T-cell subsets, B cells, macrophages and blood vessels were determined using immunohistochemistry. RESULTS: Synovial hyperplasia varied significantly between the three groups (p<0.0001). There was a significant difference in the CD3 T-cell population between the three groups (p=0.004) and between the extended-to-be and persistent group (p=0.032). CD4 expression was significantly higher in the poly and extended-to-be oligo groups (p=0.002), again the extended-to-be group had more CD4 T cells than the persistent group (p=0.008). B-cell infiltrates were more marked in the polyarticular group and were significantly higher in the extended-to-be group compared with the persistent group (p=0.005). Vascularisation was more pronounced in the polyarticular and extended-to-be oligoarticular groups, the extended-to-be group had significantly more vascularisation than the persistent group (p=0.0002). CONCLUSIONS: There are significant differences in the histomorphometric features of synovial tissue between patient subgroups. Immunohistological examination of synovial membrane biopsies may provide further insight into early disease processes in JIA.
Authors: Peter A Nigrovic; Robert A Colbert; V Michael Holers; Seza Ozen; Nicolino Ruperto; Susan D Thompson; Lucy R Wedderburn; Rae S M Yeung; Alberto Martini Journal: Nat Rev Rheumatol Date: 2021-03-17 Impact factor: 20.543
Authors: Sorcha Finnegan; Joanne Robson; Caitriona Scaife; Catherine McAllister; Stephen R Pennington; David S Gibson; Madeleine E Rooney Journal: Arthritis Res Ther Date: 2014-01-13 Impact factor: 5.156
Authors: Bence György; Tamás G Szabó; Lilla Turiák; Matthew Wright; Petra Herczeg; Zsigmond Lédeczi; Agnes Kittel; Anna Polgár; Kálmán Tóth; Beáta Dérfalvi; Gergő Zelenák; István Böröcz; Bob Carr; György Nagy; Károly Vékey; Steffen Gay; András Falus; Edit I Buzás Journal: PLoS One Date: 2012-11-20 Impact factor: 3.240
Authors: Jessica Feldt; Martin Schicht; Jessica Welss; Kolja Gelse; Stefan Sesselmann; Michael Tsokos; Eileen Socher; Fabian Garreis; Thomas Müller; Friedrich Paulsen Journal: Biomedicines Date: 2022-03-21