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Fulltext The rusty knee--pigmented villonodular synovitis

Samsudin O, Leong KK, Shukur MH, Tan KK, Ismail S

Med J Malaysia, 2004 Dec;59 Suppl F:54-6.
PMID: 15941164

Pigmented villonodular synovitis (PVNS) is a distinct but rare clinical entity often presents late with a diagnostic difficulty. Its non-specific manifestations require exclusion of several chronic inflammatory disorders and other humorous lesions but all investigations including highly predictive magnetic resonance imaging (MRI) and arthroscopic examination are non-diagnostic demanding confirmatory tissue biopsy. A typical case of such lesion is presented to highlight some potential difficulties.

Matched MeSH terms: Synovial Membrane/pathology; Synovial Membrane/radiography; Synovial Membrane/surgery
Fulltext Curcumin minimises histopathological and immunological progression in the ankle joints of collagen-induced arthritis rats

Kevin, T.T.M., Nur Idanis, A.S., Anastasha, B., Mohd Faris, M.R., Faizah, O., Taty Anna, K.

Medicine & Health, 2020;15(2):26-36.
MyJurnal

Curcumin adalah satu rempah tradisional yang mempunyai potensi untuk menyembuhkan pelbagai jenis penyakit inflamatori, termasuk artritis. Kajian ini dijalankan untuk memerhatikan kesan-kesan curcumin ke atas perubahan histopatologi dan aras interleukin-1β (IL-1β) di dalam artritis aruhan kolagen (CIA). Tiga puluh ekor tikus jantan Sprague-Dawley (150+50 g) dibahagikan kepada lima kumpulan secara rawak. Satu kumpulan dijadikan kumpulan kawalan normal (CTRL), manakala selebihnya disuntik dengan 150 μg emulsi kolagen secara subkutan pada hari 0. Kumpulan CTRL dan CIA-Curcumin-d0 masing-masing diberi suplimentasi harian minyak zaitun oil (1 ml/kg) dan curcumin (110 mg/ml/ kg) bermula pada hari 0. Kumpulan CIA-OV (kawalan negatif), CIA-Beta dan CIA-Curcumin-d14 pula, masing-masing diberi suplimentasi harian minyak zaitun (1 ml/kg), Betamethasone (0.5 mg/ml/kg), dan curcumin (110 mg/ml/kg) bermula pada hari 14. Suplimentasi harian tersebut diberi kepada tikus-tikus sehingga hari ke 42. Kajian ini menunjukkan bahawa kumpulan CIA-Beta (**P=0.00) dan CIA-Curcumin-d0 (**P=0.01) masing-masing mempamerkan purata skor histologi yang lebih rendah secara signifikan berbanding kumpulan CIA-OV. Aras IL-1β di dalam serum untuk kumpulan CIA-Beta dan CIA-Curcumin-d0 tidak meningkat secara signifikan pada hari ke 42 berbanding hari 0. Purata peningkatan aras IL-1β dari hari 0 ke hari 42 juga adalah rendah secara signifikan (**P≤0.01) untuk semua kumpulan CIA berbanding kumpulan CIA-OV. Tidak terdapat perbezaan yang signifikan dalan purata skor histologi dan aras IL-1β kumpulan of CIA-Curcumin-d0 berbanding kumpulan CIA-Beta. Kesimpulannya suplimentasi awal curcumin berpotensi untuk meminimakan perubahan yang disebabkan penyakit artritis aruhan kolagen pada tikus.

Matched MeSH terms: Synovial Membrane
Nanomedicines for improved targetability to inflamed synovium for treatment of rheumatoid arthritis: Multi-functionalization as an emerging strategy to optimize therapeutic efficacy

Fang G, Zhang Q, Pang Y, Thu HE, Hussain Z

J Control Release, 2019 06 10;303:181-208.
PMID: 31015032 DOI: 10.1016/j.jconrel.2019.04.027

Owing to its intricate autoimmune pathophysiology and significant risks of progression to other rheumatic co-morbidities (i.e., osteoporosis and osteoarthritis), a plausible therapeutic regimen is mandatory for early-stage management of rheumatoid arthritis (RA). Nevertheless, the conventional therapeutic agents particularly the corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs) have shown grander success in the treatment of RA; however, long-term use of these agents is also associated with serious adverse events. To combat these issues and optimize therapeutic efficacy, nanotechnology-based interventions have been emerged as viable option. While, nanomedicines signposted superiority over the conventional pharmacological moieties; there are still many pharmacokinetic and pharmacodynamic challenges to nanomedicines following their intravenous or intra-articular administration. To circumvent these challenges, significant adaptations such as PEGylation, surface conjugation of targeting ligand(s), and site- responsive behavior (i.e., pH-, biochemical-, or thermal-responsiveness) have been implemented. Besides, multi-functionalization of nanomedicines has been emerging as an exceptional strategy to overcome pharmacokinetic challenges, improve targetability to inflamed synovium, maximise internalisation into the activated macrophages, and improved therapeutic outcomes for treatment of RA. Therefore, this review aims to conceptualize and recapitulate the substantial evidences regarding the pharmacokinetic and pharmacodynamic superiority of multi-functionalized nanomedicines over the naked nanomedicines for site-selective targeting to inflamed synovium and rational treatment of RA and other rheumatic co-morbidities. Pharmaceutical sustainability of the multi-functionalized nanomedicines for improved biocompatibility, profound interaction with the targeting tissue/cells/sub-cellular domain, and diminished systemic toxicity has also been pondered.

Matched MeSH terms: Synovial Membrane/metabolism*
Fulltext Extracellular Vesicles in the Synovial Joint: Is there a Role in the Pathophysiology of Osteoarthritis?

Esa A, Connolly KD, Williams R, Archer CW

Malays Orthop J, 2019 Mar;13(1):1-7.
PMID: 31001376 DOI: 10.5704/MOJ.1903.012

The role of extracellular vesicles (EV) in osteoarthritis has become the focus of much research. These vesicles were isolated from several cell types found in synovial joint including chondrocytes and synovium. As articular cartilage is an avascular tissue surrounded by synovial fluid, it is believed that EV might play a crucial role in the homeostasis of cartilage and also could hold key information in the pathogenesis of osteoarthritis. This is thought to be due to activation of pro-inflammatory factors leading to a catabolic state and degradation of cartilage. In addition, due to the nature of articular cartilage lacking neuronal innervation, knowledge of EV can contribute to identification of novel biomarkers in this debilitating condition. This can be either directly isolated from aspirate of synovial fluid or from peripheral blood. Finally, EVs are known to shuttle important signalling molecules which can be utilised as unique modality in transferring therapeutic compounds in a cell free manner.

Matched MeSH terms: Synovial Membrane
Chemopreventive effects of a curcumin-like diarylpentanoid [2,6-bis(2,5-dimethoxybenzylidene)cyclohexanone] in cellular targets of rheumatoid arthritis in vitro

Lee KH, Abas F, Mohamed Alitheen NB, Shaari K, Lajis NH, Israf DA, et al.

Int J Rheum Dis, 2015 Jul;18(6):616-27.
PMID: 24832356 DOI: 10.1111/1756-185X.12341

Synovial fibroblast has emerged as a potential cellular target in progressive joint destruction in rheumatoid arthritis development. In this study, BDMC33 (2,6-bis[2,5-dimethoxybenzylidene]cyclohexanone), a curcumin analogue with enhanced anti-inflammatory activity has been synthesized and the potency of BDMC33 on molecular and cellular basis of synovial fibroblasts (SF) were evaluated in vitro.

Matched MeSH terms: Synovial Membrane/drug effects*; Synovial Membrane/immunology; Synovial Membrane/metabolism; Synovial Membrane/pathology
Fulltext The effect of relaxin on the musculoskeletal system

Dehghan F, Haerian BS, Muniandy S, Yusof A, Dragoo JL, Salleh N

Scand J Med Sci Sports, 2014 Aug;24(4):e220-9.
PMID: 24283470 DOI: 10.1111/sms.12149

Relaxin is a hormone structurally related to insulin and insulin-like growth factor, which exerts its regulatory effect on the musculoskeletal and other systems through binding to its receptor in various tissues, mediated by different signaling pathways. Relaxin alters the properties of cartilage and tendon by activating collagenase. This hormone is also involved in bone remodeling and healing of injured ligaments and skeletal muscle. In this review, we have summarized the literature on the effect of relaxin in musculoskeletal system to provide a broad perspective for future studies in this field.

Matched MeSH terms: Synovial Membrane/physiology
Fulltext Ultrastructural characteristics of synovial effusion cells in some arthropathies

Kapitonova MY, Othman M

Malays J Pathol, 2004 Dec;26(2):73-87.
PMID: 16329559

OBJECTIVE: To evaluate the range of activation changes of polymorphonuclear leukocytes (PMN) and the ratio of apoptosis and necrosis in synovial effusions of patients with various arthropathies, and to reveal possible correlations with clinical variants of joint inflammation.
METHODS: Synovial effusions were aspirated from the knee joints of patients with rheumatoid arthritis (RA, 28 cases), and seronegative spondyloarthritides (SSA): Reiter's disease (RD, 9 cases), peripheral form of the ankylosing spondyloarthritis (6 cases) and psoriatic arthritis (6 cases); and primary osteoarthritis (OA, 9 cases). Cytospin preparations were processed for transmission electron microscopy and assessed for the incidence of apoptosis, necrosis, and cytophagocytic cells (CPC) in the synovial fluid (SF). The range of activation changes of the neutrophil granulocytes, the dominating cell population in the arthritic SF, was evaluated.
RESULTS: In all arthropathies under investigation most of the synovial effusion cells had intact ultrastructure with a certain amount of apoptotic cells dominating over the cells with signs of necrosis, and a few CPC. The highest rate of apoptosis was discovered in the synovial effusions of patients with RA, the lowest in those with OA, while the rate of CPC among the inflammatory joint diseases was the lowest in RA. In RA the current disease activity correlated with the incidence of apoptotic cells and CPC, while the clinical stage was related only to the CPC rate. These data suggest that in RA, despite exposure to the anti-apoptotic signals, apoptosis of the synovial effusion PMN is maintained at a significantly higher level than in non-rheumatoid arthropathies, both inflammatory (SSA) and degenerative (OA), providing elimination of the neutrophils accumulating in the joint cavity and thus stimulating resolution of the joint inflammation.

Matched MeSH terms: Synovial Membrane/ultrastructure*
Modulation of the mechanical responses of synovial fibroblasts by osteoarthritis-associated inflammatory stressors

Jamal J, Roebuck MM, Lee SY, Frostick SP, Abbas AA, Merican AM, et al.

Int J Biochem Cell Biol, 2020 09;126:105800.
PMID: 32673644 DOI: 10.1016/j.biocel.2020.105800

OBJECTIVES: To compare mechanobiological response of synovial fibroblasts (SFb) from OA patient cohorts under mechanical load and inflammatory stressors for better understanding of SFb homeostatic functions.
METHODS: Primary SFb isolated from knee synovium of OA obese (OA-ob:SFb), OA-pre-obese (OA-Pob:SFb), non-OA arthroscopic (scope:SFb), and non-OA arthroscopic with cartilage damage (scope-CD:SFb) were exposed to OA-conditioned media (OACM), derived from OA obese (OA-ob:CM), OA-pre-obese (OA-Pob:CM), and mechanical stretch at either 0 %, 6 % or 10 % for 24 h. Differences in the mRNA levels of genes involved in extracellular matrix production, inflammation and secretory activity were measured.
RESULTS: Despite the significant BMI differences between the OA-ob and OA-Pob groups, OA-Pob has more patients with underlying dyslipidaemia, and low-grade synovitis with higher levels of secreted proteins, CXCL8, COL4A1, CCL4, SPARC and FGF2 in OA-Pob:CM. All primary SFb exhibited anti-proliferative activity with both OA-CM. Mechanical stretch stimulated lubricin production in scope:SFb, higher TGFβ1 and COL1A1 expressions in scope-CD:SFb. OA-Pob:CM stimulated greater detrimental effects than the OA-ob:CM, with higher pro-inflammatory cytokines, IL1β, IL6, COX2 and proteases such as aggrecanases, ADAMTS4 and ADAMTS5, and lower ECM matrix, COL1A1 expressions in all SFb. OA-ob:SFb were unresponsive but expressed higher pro-inflammatory cytokines under OA-Pob:CM treatment.
CONCLUSION: Both mechanical and inflammatory stressors regulate SFb molecular functions with heterogeneity in responses that are dependent on their pathological tissue of origins. While mechanical stretch promotes a favorable effect with enhanced lubricin production in scope:SFb and TGFβ1 and COL1A1 in scope-CD:SFb, the presence of excessively high OA-associated inflammatory mediators in OA-Pob:CM, predominantly SPARC, CXCL8 and FGF2 drive all SFb regardless of pathology, towards greater pro-inflammatory activities.

Matched MeSH terms: Synovial Membrane/pathology*
Relation of Doppler ultrasound synovitis versus clinical synovitis with changes in native complement component levels in rheumatoid arthritis patients treated with biologic disease-modifying anti-rheumatic drugs

Montoro Alvarez M, Chong OY, Janta I, González C, López-Longo J, Monteagudo I, et al.

Clin Exp Rheumatol, 2015 Mar-Apr;33(2):141-5.
PMID: 25665178

The complement system plays a fundamental role in mediating the activity of rheumatoid arthritis (RA). Biologic therapy can reduce native complement component levels and its activation. We aimed to study the relation of Doppler ultrasound (US) synovitis versus clinical synovitis with changes in native complement component levels in RA patients on biologic therapy.

Matched MeSH terms: Synovial Membrane/drug effects*; Synovial Membrane/immunology; Synovial Membrane/ultrasonography
Fulltext Intra-articular haemangioma of the knee in the skeletally immature

Wong KA, Singh VA, Pailoor J

Singapore Med J, 2013 Nov;54(11):e228-9.
PMID: 24276110

Intra-articular haemangioma is a rare and uncommon condition that sometimes presents in infants. The lesion can be a diagnostic challenge, with misdiagnosis often leading to delayed diagnosis and treatment. It is essential to establish and treat the condition early, as intra-articular haemangioma can lead to destruction of the joint and secondary arthrosis. Herein, we report the case of a five-year-old boy who presented with intra-articular haemangioma and discuss the management of his condition.

Matched MeSH terms: Synovial Membrane/pathology
Differential effects of activated protein C on synovial fibroblasts in response to hypoxia and normoxia

Park YG, Choi J, Song I, Park SY, Seol JW, Jackson CJ

Sains Malaysiana, 2017;46:1895-1902.

Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of the joints and their lining or synovium. Previous studies showed that the synovium in RA patients is more hypoxic than normal synovium. Activated protein C (APC) has anticoagulant and anti-inflammatory effects and is highly expressed in the joints of RA patients. We examined the effect of APC on RA and normal synovial fibroblasts under hypoxic conditions. Human synovial fibroblasts were isolated from the synovial tissues of RA patients and normal controls and cells were exposed to recombinant APC under normoxic (21% oxygen) or hypoxic (1% oxygen) conditions. Cell proliferation was measured using MTT assays. Cell lysates and conditioned media were collected and assayed for matrix metalloproteinase (MMP)-2, MMP-9 and p38 using zymography and western blots. Proliferation of both normal and RA synovial fibroblasts dose-dependently increased after APC treatment in normoxic conditions. Under hypoxia, APC enhanced RA cell proliferation but had no effect on normal fibroblasts. MMP-2 production and activation were significantly augmented by APC in both cell types under normoxia and hypoxia conditions. However, activated MMP-2 was more reduced in cells under hypoxia than normoxia. APC substantially reduced the phosphorylation of p38 in normal and RA synovial fibroblasts under hypoxia. No difference in p38 phosphorylation was observed under normoxia. The receptor for APC, endothelial protein C receptor (EPCR), was elevated in normal fibroblasts under hypoxic conditions whereas in RA cells, EPCR was highly expressed under both normoxic and hypoxic conditions. We found that hypoxia enhanced the effect of APC on RA synovial fibroblasts through activation of MMP2 and inhibition of p38 phosphorylation. Our results suggested that APC may suppress joint destruction and progression of inflammation in a hypoxic RA environment.

Matched MeSH terms: Synovial Membrane
Fulltext Lipoma Arborescens of the knee: a case report of rare entity

Ikmal Hisyam Bakrin, Hasni Mahayidin, Khairul Shakir Ab Rahman, Wan Irnawati Wan Ab Rahman, Sazali Satari, Asrul Fahmi Azizan

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):60-63.
MyJurnal

Lipoma arborescens is a non-neoplastic, reactive condition due to chronic synovial inflammation and irritation, characterized by frond-like or villous proliferation of mature adipose tissue covered by hyperplastic synovium. The knee is the most commonly affected site particularly the suprapatellar pouch. We report a case of lipoma arborescens affecting the right knee of an elderly Chinese gentleman associated with bilateral knee and hand osteoarthritis. He presented with progressive worsening of right knee swelling and pain. Partial synovectomy of the right knee was performed and no lesion recurrence was noted at one year post-operation. The clinical and imaging findings, pathological features, together with differential diagnoses were discussed.

Matched MeSH terms: Synovial Membrane
Fulltext Role of radiosynovectomy in the treatment of rheumatoid arthritis and hemophilic arthropathies

Das B

Biomed Imaging Interv J, 2007 Oct;3(4):e45.
PMID: 21614297 DOI: 10.2349/biij.3.4.e45

Radiosynovectomy is a novel method of treatment for several acute and chronic inflammatory joint disorders. A small amount of a beta-emitting radionuclide is injected into the affected joint delivering a radiation dose of 70 to 100 Gy to the synovia. The proliferative tissue is destroyed, secretion of fluid and accumulation of inflammation causing cellular compounds stops and the joint surfaces become fibrosed, providing long term symptom relief. The radionuclides are injected in colloidal form so that they remain in the synovium and are not transported by lymphatic vessels causing radiation exposure to other organs. Complete reduction of knee joint swelling has been seen in above 40% and pain relief in 88% of patients. Wrist, elbow, shoulder, ankle and hip joints showed significant improvement in 50-60% and restoration of normal function and long term pain relief has been achieved in about 70% of small finger joints. In hemophilic arthropathies complete cessation of bleeding in about 60% and improved mobility in 75% of patients has been reported.

Matched MeSH terms: Synovial Membrane

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