Behavior of the synovial vascular pattern in patients with active rheumatoid arthritis
Keywords:
rheumatoid arthritis, activity, vascular morphology.Abstract
ABSTRACT
Introduction: Rheumatoid arthritis is a chronic and progressive inflammatory disorder that manifests as symmetric polyarthritis of small and large joints. This polyarthritis can lead to structural joint and periarticular damage, as well as the consequences of systemic inflammation.
Objective: To identify whether there is an association between synovial vascular patterns and overall disease activity in patients with rheumatoid arthritis.
Methods: A descriptive cross-sectional study was conducted during the period from January 2008 to July 2012. The study population consisted of 136 patients with rheumatoid arthritis who experienced persistent pain and inflammation in a single joint for more than three months and who underwent arthroscopy.
Results: The cases under study were predominantly characterized by an average age of 52.4 years; 89 women (84%); 69 White individuals (65%) and an average disease duration of 20.5 years. Women had a higher frequency of moderate and high activity with statistically significant differences (p < 0.018). Straight vessels were more frequent in women, with the difference compared to men being statistically significant (p = 0.026). The presence of fibrin showed a significant association with the presence of straight vessels (p = 0.028). The presence of straight vessels was associated with moderate and high disease activity with a p value of 0.012.
Conclusions: Female sex and the presence of straight vessels in patients with active rheumatoid arthritis were associated. The straight vascular pattern is associated with macroscopic characteristics of the synovium that indicate activity, such as the presence of fibrin and glove finger images. It was also more frequently associated with moderate and high activity levels, according to the simplified rheumatoid arthritis activity index.
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Referencias bibliográficas
1. Díaz-González F, Hernández-Hernández MV. Rheumatoid arthritis. Med Clin (Barc). 2023 Dec 22;161(12):533-542. English, Spanish. doi: 10.1016/j.medcli.2023.07.014. Epub 2023 Aug 9. PMID: 37567824.
2. Kraan MC, Patel DD, Haringman JJ, Smith MD, Weedon H, Ahern MJ, Breedveld FC, Tak PP. The development of clinical signs of rheumatoid synovial inflammation is associated with increased synthesis of the chemokine CXCL8 (interleukin-8). Arthritis Res. 2001;3(1):65-71. doi: 10.1186/ar141. Epub 2000 Nov 9. PMID: 11178128; PMCID: PMC17826.
3. Stevens CR, Blake DR, Merry P, Revell PA, Levick JR. A comparative study by morphometry of the microvasculature in normal and rheumatoid synovium. Arthritis Rheum. 1991 Dec;34(12):1508-13. doi: 10.1002/art.1780341206. PMID: 1747135.
4. Cañete JD, Rodríguez JR, Salvador G, Gómez-Centeno A, Muñoz-Gómez J, Sanmartí R. Diagnostic usefulness of synovial vascular morphology in chronic arthritis. A systematic survey of 100 cases. Semin Arthritis Rheum. 2003 Jun;32(6):378-87. doi: 10.1053/sarh.2002.50004. PMID: 12833246.
5. Studenic P, Aletaha D, de Wit M, Stamm TA, Alasti F, Lacaille D, Smolen JS, Felson DT. American College of Rheumatology/EULAR remission criteria for rheumatoid arthritis: 2022 revision. Ann Rheum Dis. 2023 Jan;82(1):74-80. doi: 10.1136/ard-2022-223413. Epub 2022 Oct 24. PMID: 36280238; PMCID: PMC9811102.
6. Fiocco U, Cozzi L, Chieco-Bianchi F, Rigon C, Vezzù M, Favero E, Ferro F, Sfriso P, Rubaltelli L, Nardacchione R, Todesco S. Vascular changes in psoriatic knee joint synovitis. J Rheumatol. 2001 Nov;28(11):2480-6. PMID: 11708422.
7. Reece RJ, Canete JD, Parsons WJ, Emery P, Veale DJ. Distinct vascular patterns of early synovitis in psoriatic, reactive, and rheumatoid arthritis. Arthritis Rheum. 1999 Jul;42(7):1481-4. doi: 10.1002/1529-0131(199907)42:7<1481::AID-ANR23>3.0.CO;2-E. PMID: 10403277.
8. Boers M, Kostense PJ, Verhoeven AC, van der Linden S. COBRA Trial Group. Combinatie therapie Bij Reumatoide Artritis. Inflammation and damage in an individual joint predict further damage in that joint in patients with early Rheumatoid arthritis. Arthritis Rheum 2001; 44:2242–6.
9. Smolen JS, Van Der Heijde DM, St Clair EW, Emery P, Bathon JM, Keystone E, Maini RN, et al.; Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset (ASPIRE) Study Group. Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial. Arthritis Rheum. 2006 Mar;54(3):702-10. doi: 10.1002/art.21678. PMID: 16508926.
10. Ahlmén M, Svensson B, Albertsson K, Forslind K, Hafström I; BARFOT Study Group. Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage. Ann Rheum Dis. 2010 Jan;69(1):230-3. doi: 10.1136/ard.2008.102244. PMID: 19158113.
11. Barnabe C, Bessette L, Flanagan C, Leclercq S, Steiman A, Kalache F, et al. Sex differences in pain scores and localization in inflammatory arthritis: a systematic review and metaanalysis. J Rheumatol. 2012 Jun;39(6):1221-30. doi: 10.3899/jrheum.111393. Epub 2012 Apr 15. PMID: 22505697.
12. Hallert E, Björk M, Dahlström O, Skogh T, Thyberg I. Disease activity and disability in women and men with early rheumatoid arthritis (RA): an 8-year followup of a Swedish early RA project. Arthritis Care Res (Hoboken). 2012 Aug;64(8):1101-7. doi: 10.1002/acr.21662. PMID: 22392813.
13. Haringman JJ, Vinkenoog M, Gerlag DM, Smeets TJ, Zwinderman AH, Tak PP. Reliability of computerized image analysis for the evaluation of serial synovial biopsies in randomized controlled trials in rheumatoid arthritis. Arthritis Res Ther. 2005;7(4):R862-7. doi: 10.1186/ar1757. Epub 2005 May 12. PMID: 15987488; PMCID: PMC1175038.
14. Emery P. The Dunlop-Dottridge Lecture: prognosis in inflammatory arthritis: the value of HLA genotyping and the oncological analogy. J Rheumatol. 1997 Jul;24(7):1436-42. PMID: 9228150.
15. Emery P, McInnes IB, van Vollenhoven R, Kraan MC. Clinical identification and treatment of a rapidly progressing disease state in patients with rheumatoid arthritis. Rheumatology (Oxford). 2008 Apr;47(4):392-8. doi: 10.1093/rheumatology/kem257. Epub 2007 Dec 18. PMID: 18094000.
16. Chico Capote A, Estévez del Toro M, Acuña Aguijarte W, Domínguez Álvarez C, Jiménez Paneque R. Imagen artroscópica y biopsia sinovial como ayuda en el diagnóstico de la artritis reumatoide. Rev cubana med v.43 n.5-6 Ciudad de la Habana sep.-dic. 2004
17. Paus AC, Refsum S, Førre O. Histopathologic changes in arthroscopic synovial biopsies before and after open synovectomy in patients with chronic inflammatory joint diseases. Scand J Rheumatol. 1990;19(3):202-8. doi: 10.3109/03009749009095044. PMID: 2359998.
18. Tak PP, Bresnihan B. The pathogenesis and prevention of joint damage in rheumatoid arthritis: advances from synovial biopsy and tissue analysis. Arthritis Rheum. 2000 Dec;43(12):2619-33. doi: 10.1002/1529-0131(200012)43:12<2619::AID-ANR1>3.0.CO;2-V. PMID: 11145019.
19. Kim HY, Kim HJ, Min HS, Kim S, Park WS, Park SH, Chung DH. NKT cells promote antibody-induced joint inflammation by suppressing transforming growth factor beta1 production. J Exp Med. 2005 Jan 3;201(1):41-7. doi: 10.1084/jem.20041400. PMID: 15630137; PMCID: PMC2212773.
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