PATOGENESI DELL'INFIAMMAZIONE SINOVIALE REUMATOIDE

The influence of immunological phenomena in rheumatoid arthritis is clear. Microscopic study has shown the low level of complement (C') in the synovial fluid (SF); the presence of immune complexes (IC); and of rheumatic factor (RF) of the IgM class or of other classes; the lymphatic proliferation in the synovia; the activation of poly morphonuclears with or without liberation of protease enzymes. The authors studied the C' and some enzymes in 27 cases of RA and 12 cases of degenerative arthropathy (DA), the C' was significantly reduced in RA both with regard to the total activity (CH50) and the components C'4, C'3PA; the enzymes were significantly increased in RA with regard to the total LDH, LDH4, LDH5, AcP and LAP. The titre of the CH50 was lower in the SF of the RA than in that of the DA, while the serum was within normal limits in both diseases. The behaviour of the C'3 was in complete agreement with that of the C'H50. If an analysis is made of the ratio of C'H50 SF/CH50 S there emerges still more clearly the diversity of behaviour of the RA with respect to DA. The autors also studied the dynamics of inflammation when antiphlogistics are used locally. The results of the two studies are explained in the text and made clear in tables. This is an informative article that needs to be read in its entirety.