Arthritis—An Example of Inflammation Based on Particles
Exudative leukocytes from synovial fluids of patients with several types of arthritis were examined by light microscopy, immunofluorescence, and electron microscopy. The fine structure of these leukocytes andtheir associated intracellular particles was examined in rheumatoid arthritis, gout, and pseudogout. Immune complexes and crystals served as examples of disease-related particles. A variety of particulate materials was observed within the neutrophils from patients with rheumatoid arthritis. These were segregated in phagosomes. Intraleukocytic crystals of sodium urate observed only in gouty arthritis were frequently not contained within a membrane-bounded vacuole. In contrast, crystals of calcium pyrophosphate found only in pseudogout were consistently within membrane-limited vacuoles at their intraleukocytic location. Other particles such as fibrin flakes and cytoplasmic buds shed from the exudative leukocytes were not disease related. Neutrophil granules interacted with each of these intracellular particles. A unifying concept of joint inflammation is presented which illustrates interrelationships between the various types of arthritis when particles serve as the common denominator.
KeywordsRheumatoid Arthritis Septic Arthritis Joint Inflammation Gouty Arthritis Inflammation Base
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