岡山医学会 Acta Medica Okayama 0030-1558 89 3-4 1977 慢性関節リウマチ患者のリソゾーム酵素活性に関する研究 第二篇 関節液中の線溶系とリソゾーム酵素活性の線維素溶解剤関節処置前后における変動について 309 316 EN Taketo Terami Urokinase was administered to knee joint effusions of rheumatoid arthritis (RA) patients who showed no effects to various other RA treatment methods. The fibrinolytic system and the lysosomal enzyme activities of the synovial fluid of 19 RA patients and 10 osteoarthritis (OA) patients were examined before and after treated with urokinase, and the clinical effects of urokinase treatment were examined. 1, Plasmin activities were not present in the synovial fluid of RA patients, but streptokinase activating plasmin (SK-pl.) and euglobulin streptokinase activating plasmin (eug.-SK-pl.) activities were present. Fibrin degradation product (FDP) levels were higher in synovial fluid of RA patients than OA patients. 2, Urokinase was injected into the synovial cavity and at 24 hours after injection, the synovial fluid was collected and the fibrinolytic system was examined. Plasmin activity was not present. Under urokinase treatment, SK-pl. activity was not altered, and in some cases the eug.-SK-pl. activities were elevated compared to untreated synovial fluid. FDP was elevated and activated the fibrinolytic activity. 3, After treatment with urokinase, synovial fluid showed a arise in cathepsin D and β-glucuronidase activities and in synovial cell count. This shows that the synovial inflamation was increased temporarrly by urokinase treatment. 4, Urokinase treatment was not effected in RA cases that showed a low plasminogen and a high plasmin inhibitor in synovial fluid. Joint effusion was not decrease after urokinase treatment in RA cases that showed elevation of plasmin inhibitor and no elevation of FDP levels. 5, Urokinase treatment was effective in about 80% of cases for decreasing RA joint effusion. Urokinase administration resulting in the dissolving of fibrin in RA synovial fluid is a useful treatment. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 89 3-4 1977 慢性関節リウマチ患者のリソゾーム酵素活性に関する研究 第一篇 関節疾患におけるリソゾーム酵素活性について 299 308 EN Taketo Terami Lysosomal enzymes were examined in synovial fluid, synovium, synovial fluid leukocytes and peripheral blood leukocytes of 40 rheumatoid arthritis (RA) patients and in synovial fluid and synovium of 19 osteoarthritis (OA) patients. Complement level and anticomplementary activity were examined in 13 RA synovial fluid. The results are summarized as follows: 1, In the supernatant synovial fluid and the synovium of RA patients, cathepsin D (C-D) and β-glucuronidase (β-G) activities were higher than those of OA patients. A positive correlation was present between the synovial fluid leukocyte count and C-D activity and between synovial fluid leukocyte count and β-G activity. RA synovial localization of β-G activity was demonstrated by light microscopy. The synovial lining cell of RA patients showed the strongest β-G localization. 2, No significant differences were found in C-D and β-G activities between RA synovial fluid leukocytes, RA peripheral blood leukocytes and normal human peripheral blood leukocytes. These results suggested that there were little differences in the inflammatory leukocytes and the noninflamatory leukocytes. 3, C-D and β-G activities in the supernatant synovial fluid and synovial fluid leukocytes were higher in RA patients with positive RF in synovial fluid than negative RF in synovial fluid. The results of this study suggested that the RF was displaced to the inflamation RA joint. 4, The presence of low complement levels and anticomplementary activity in RA synovial fluid suggested the role of the immune complex in the RA synovial cavity. 5, These results suggest that the high level of lysosomal enzymes in RA synovial fluid was due chiefly to the synovial membrane. No potential conflict of interest relevant to this article was reported.