ABSTRACT
The assumption of inflamation as the only cause of the complex clinical picture of rheumatoid atrhritis does not correspond to facts. We have found and proven the existence of three seemingly unconnected mechanisms, and only their combination can account for the general clinical picture of rheumatoid arthritis. They are: 1. immunologic synovitis, responsible for pain, swelling and stiffnes; 2. oncological process ("tumorlike proliferation"), responsible for the destruction of joints; 3. Primary necrotizing process, responsible for the (sometimes lethal) destructions in the heart and blood vessels.
Subject(s)
Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/pathology , Arthritis, Rheumatoid/physiopathology , Humans , Joints/pathologyABSTRACT
Expression patterns of cell cycle regulating gene products and Ki-67 in proliferating synovial cells of primary and recurrent pigmented villonodular synovitis (PVNS) in localized and diffuse lesions were examined by immunohistochemistry. Alterations of cell cycle-related proteins were seen in 98.7% of analyzed lesions. Both RB- and p53 pathways play a role in cell cycle dysregulation in PVNS. The RB pathway was more frequently altered in primary disease, while alterations of the p53 pathway seemed to be more important in recurrent lesions, regardless of the histomorphological type of disease. Ki-67 proliferation rate was elevated in recurrent tumors.
Subject(s)
Cell Cycle Proteins/metabolism , DNA-Binding Proteins/metabolism , Retinoblastoma Protein/metabolism , Synovitis, Pigmented Villonodular/metabolism , Transcription Factors/metabolism , Tumor Suppressor Protein p53/metabolism , Adolescent , Adult , Aged , E2F Transcription Factors , Female , Humans , Immunoenzyme Techniques , Ki-67 Antigen/metabolism , Male , Middle Aged , Recurrence , Synovitis, Pigmented Villonodular/pathologyABSTRACT
BACKGROUND: The incidence and morphological features of rheumatoid necroses (RN) in the forefoot are unknown. METHODS: Biopsy material from 223 patients with seropositive rheumatoid arthritis (RA) was examined morphologically. The incidence and morphological features of RN in the forefoot were evaluated. RESULTS: RN was found in 65% of cases, which had not been suspected clinically. It was correlated with pain in 69% of cases. CONCLUSIONS: Rheumatoid necrosis contributes to the development of pain and foot deformation. It can be a significant factor worsening the clinical behavior in seropositive RA patients.
