Rheumatology International

, Volume 4, Issue 1, pp 13–17 | Cite as

Platelets in the synovial fluid of patients with rheumatoid arthritis

  • M. Farr
  • A. Wainwright
  • M. Salmon
  • C. A. Hollywell
  • P. A. Bacon
Originals
Received:
Accepted:

Summary

In a study of synovial fluid from 110 patients with various forms of arthritis, platelets were identified in the synovial fluid of all the 50 rheumatoids, in 18 out of the 25 (72%) with osteoarthritis and in all 35 of those with other forms of inflammatory osteoarthrosis. Identification of platelets by light microscopy was confirmed by electron microscopy. Platelet counts were significantly higher in rheumatoid fluid (mean 14 988/mm3; range 1000–65 000/mm3) compared with fluid from patients with osteoarthrosis (mean 1592/mm3; 0–10 000/mm3). In addition, significantly higher platelet counts were found in the synovial fluid (SF) of inflamed joints. There was a positive correlation between the SF platelet count and the total white cell count, polymorph count, hydrogen ion concentration, knee score, acid phosphatase and 5-nucleotidase activity and a negative correlation with the glucose level. All these factors indicate joint activity. Finally, platelet numbers correlated with SF levels of immunoglobulin M, and seropositive patients had significantly higher platelet counts in the SF compared with seronegative patients. Rheumatoid patients with thrombocytosis also had higher SF platelet counts. The close relationship of the SF platelet count to other indices of inflammation supports the concept that platelets may directly contribute to synovial inflammation by a variety of pathways.

Key words

Platelets Synovial fluid Inflammation 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Walsh PN (1975) The possible role of platelet coagulant activities in the pathogenesis of venous thrombi. Thromb Diath Haemorrh (Stuttg) 33:435Google Scholar
  2. 2.
    Silver MJ, Smith JB, Ingerman CM (1974) Blood platelets and the inflammatory process. Agents Actions 4:233–240Google Scholar
  3. 3.
    Conn DL, McDuffie FC, Kazmier FJ, Schroeter AL, Sun NCJ (1976) Coagulation abnormalities in rheumatoid disease. Arthritis Theum 19:1237–1243Google Scholar
  4. 4.
    Jorgansen L, Hovig T, Rowsell HC, Mustard JF (1970) ADP induced platelet aggregation and vascular injury in swine and rabbits. Am J Pathol 61:161–176Google Scholar
  5. 5.
    Henson PM (1970) Release of vasoactive amines from rabbit platelets induced by sensitized mononuclear leukocytes and antigen. J Exp Med 131:287–306Google Scholar
  6. 6.
    Henson PM (1970) Mechanisms of release of constituents from rabbit platelets by antigen-antibody complexes and complement. J Immunol 105:476–501Google Scholar
  7. 7.
    Mustard JF, Packham MA (1968) Platelet phagocytosis. Ser Haematol 1:168Google Scholar
  8. 8.
    Nachman RL (1978) The platelet as an inflammatory cell. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New YorkGoogle Scholar
  9. 9.
    Henson PM, Spiegelberg HL (1973) Release of serotonin from human platelets induced by aggregated immunoglobulins of different classes and subclasses. J Clin Invest 52:1282–1288Google Scholar
  10. 10.
    Caygill JC, Pitkeathky DA (1966) A study of β-acetylglucosaminase and acid phosphatase in pathological joint fluids. Ann Rheum Dis 25:137–144Google Scholar
  11. 11.
    Jasani MK, Katori M, Lewis GP (1969) Intracellular enzymes and kinin enzymes in synovial fluid in joint disease. Ann Rheum Dis 28:497–512Google Scholar
  12. 12.
    Farr M, Kendall MJ, Shuttleworth R, Meynell MJ, Hawkins CF (1973) Source and significance of 5-nucleotidase in synovial fluid. Ann Rheum Dis 32:326–330Google Scholar
  13. 13.
    Selroos O (1972) Thrombocytosis in rheumatoid arthritis. Scand J Rheumatol 1:136–140Google Scholar
  14. 14.
    Hutchinson RM, Davis P, Jayson MIV (1976) Thrombocytosis in rheumatoid arthritis. Ann Rheum Dis 35:138–142Google Scholar
  15. 15.
    Farr M, Scott DL, Constable T, Hawker RJ, Hawkins CF (1981) Platelets and rheumatoid arthritis. Ann Rheum Dis 40:617Google Scholar
  16. 16.
    Endresen GKM (1981) Investigation of blood platelets in synovial fluid from patients with rheumatoid arthritis. Scand J Rheumatol 10:204–208Google Scholar
  17. 17.
    Ropes MW, Bennet GA, Cobb S, Jacox R, Jesser RA (1959) Diagnostic criteria for rheumatoid arthritis, 1958 revision. Ann Rheum Dis 18:49–53Google Scholar
  18. 18.
    Spurr R (1969) A low viscosity epoxy resin embedding medium for electron microscopy. J Ultrastruct Res 26:31–43Google Scholar
  19. 19.
    Roy GV, Brewer ME, Hayden JE (1971) Sodium thymolphthalein monophosphatate: a new acid phosphate substrate with greater specificity for the prostatic enzyme in serum. Clin Chem 17:1093–1102Google Scholar
  20. 20.
    Persijn JP, Slik W Van der, Kramer K, Ruitjet CA de (1968) A new method for the determination of serum nucleotidase. Z Klin Chemie 6:441–446Google Scholar
  21. 21.
    Chayen J, Bitensky L (1971) Lysosomal enzymes and inflammation with particular reference to rheumatoid diseases. Ann Rheum Dis 30:522–536Google Scholar
  22. 22.
    Janoff A (1975) At least three human neutrophil lysosomal proteases are capable of degrading joint connective tissues. Ann NY Acad Sci 256:402Google Scholar
  23. 23.
    Ropes MW, Bauer W (1953) Synovial fluid changes, Harvard University Press, Cambridge, Mass, pp 24, 67Google Scholar
  24. 24.
    Farr M, Kendall MJ, Bold AM, Hawkins CF (1981) Significance of pH in synovial fluid. Ann Rheum Dis 40:621Google Scholar
  25. 25.
    Kushner I, Somerville JA (1971) Permeability of human synovial membrane to plasma proteins: relationship to molecular size and inflammation. Arthritis Rheum 14: 560–570Google Scholar
  26. 26.
    Pfueller SL, Weber S, Lüscher EF (1977) Studies of the mechanism of the human platelet release reaction induced by immunologic stimuli. III. Relationship between the binding of soluble IgG aggregates to the Fc receptor and cell response in the presence and absence of plasma. J Immunol 118:514–524Google Scholar
  27. 27.
    Cheng CM, Hawiger J (1979) Affinity isolation and characterisation of immunoglobulin G Fc fragment binding glycoprotein from human blood platelets. J Biol Chem R54: 2165Google Scholar
  28. 28.
    Lüscher EF, Pfueller SL (1978) Platelets as a target of immunologic reactions. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New York, pp 261–268Google Scholar
  29. 29.
    O'Brien JR (1968) Effect of anti-inflammatory agents on platelets. Lancet I:894Google Scholar
  30. 30.
    Copley AL (1978) Platelets and physiological defence mechanisms. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New York, pp 161–197Google Scholar
  31. 31.
    Zvaiffer NJ (1974) An extravascular immune complex disease. Arthritis Rheum 17:297–305Google Scholar
  32. 32.
    Mustard JF, Movat Hz, Macmorine DRL, Sényi A (1965) Release of permeability factors from the blood platelets. Proc Soc Exp Biol Med 119:988–991Google Scholar
  33. 33.
    Smith JB, Ingerman C, Koesis JJ, Silver MJ (1973) Formation of prostaglandins during the aggregation of human blood platelets. J Clin Invest 52:965–969Google Scholar
  34. 34.
    Nachman RL, Ferris B (1968) Studies on human platelet protease activity. Clin Invest 47:2530–2540Google Scholar
  35. 35.
    Mills DCB, Robb IA, Roberts GCK (1968) The release of nucleotides, 5HT, and enzymes from human blood platelets during aggregation. J Physiol 195:715–729Google Scholar
  36. 36.
    Chelsney C, Harper E, Colman RW (1974) Human platelets collagenase. J Clin Invest 53:1647–1654Google Scholar
  37. 37.
    Legrand Y, Pignaud G (1975) Human blood platelet elastase and proelastase. Pathol Biol 23:546Google Scholar
  38. 38.
    Weksler BB, Coupal CE (1973) Platelet-dependent generation of chemotactic activity in serum. J Exp Med 137:1419–1430Google Scholar
  39. 39.
    Yeatts RP, Turner R, Collins R, Kaufmann J, Mashburn H (1978) Soluble and insoluble immune complex-platelet interactions in rheumatoid inflammation. Ann Rheum Dis 37: 421–427Google Scholar

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • M. Farr
    • 1
  • A. Wainwright
    • 1
  • M. Salmon
    • 1
  • C. A. Hollywell
    • 1
  • P. A. Bacon
    • 1
  1. 1.Departments of Investigative Pathology and Rheumatology, The Medical SchoolThe University of BirminghamBirminghamUK

Personalised recommendations