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The deposition of immunoglobulins and complement components in osteoarthritic cartilage

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Summary

In a prospective study of 117 patients having reconstructive surgery for osteoarthritis, biopsies of hyaline articular cartilage and meniscal fibrocartilage were taken which exhibited immunofluorescence in their articular surfaces, for at least two immuno-globulins (Ig) and β1c. These could represent immune complexes. The cases were classified into three Groups according to clinical, radiological and laboratory features, (1) non-arthritic — 27 (3% positive); (2) secondary degenerative — 32 (16% positive); (3) idiopathic osteoarthritic — 89 (51% positive). The incidence of positive findings in Group III was significant at p<0.001 and <0.005 levels respectively as compared to those of Groups I and II. Our study of the disease features and their associated laboratory parameters indicated the following: positive findings correlated with an older mean age and longer disease duration. The gradings for mononuclear cell infiltration in synovial biopsies of Group III were more than two times higher than those of secondary arthritics. Group III also had an increased incidence of circulating auto-antibodies. A careful review of clinical features has not suggested a mixed population with rheumatoid disease but rather that Group III represents part of the spectrum of primary generalised osteoarthritis. These data suggest involvement of local immune mechanisms in cartilage degradation in the joints of those patients with longer term involvement.

Résumé

On a constaté, au cours d'une étude prospective portant sur 117 malades ayant subi une intervention chirurgicale reconstructrice pour arthrose, qu'un grand nombre de biopsies du fibro-cartilage méniscal et du cartilage articulaire hyalin, présentaient à l'immunofluorescence deux immuno-globulines (Ig) et β1c au moins. Celles-ci pourraient représenter des complexes immuns. Ces observations ont été classées en trois groupes d'après leurs caractéristiques cliniques et radiologiques et les données du laboratoire: (1) 27 non arthrosiques (3% de cas positifs); (2) 32 rhumatismes dégénératifs secondaires (16% de cas positifs) et (3) 89 arthroses idiopathiques (51% de cas positifs). La fréquence de la présence d'immunoglobulines dans le groupe III est significative aux niveaux p<0.001 et <0.005 respectivement, par rapport à celle des groupes I et II. L'étude des caractéristiques de la maladie et des paramètres de laboratoire qui y sont associés met en évidence les faits suivants: la présence d'immuno-globulines correspond à un âge moyen plus avancé et à une durée plus longue de la maladie. L'infiltration cellulaire mononucléaire était deux fois plus élevée dans les biopsies synoviales du groupe III que dans celles des rhumatismes secondaires. Le groupe III présentait également une fréquence accrue d'auto-anticorps circulants. Un examen approfondi des caractéristiques cliniques permet de penser que le groupe III ne représente pas une population hétérogène incluant des cas d'arthrite rhumatoïde, mais plutôt qu'il représente une part de la polyarthrite primaire généralisée. Il semble, d'après ces données, que des mécanismes immuns locaux jouent un rôle, de manière temporaire, au niveau des articulations de ces malades et, à long terme, dans la dégénérescence cartilagineuse.

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Correspondence to T. D. V. Cooke.

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Cooke, T.D.V., Bennett, E.L. & Ohno, O. The deposition of immunoglobulins and complement components in osteoarthritic cartilage. International Orthopaedics 4, 211–217 (1980). https://doi.org/10.1007/BF00268158

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Key words

  • Immunoglobulins deposition
  • Osteoarthritis
  • Cartilage