Studies on the Pathogenesis of Rheumatoid Joint Inflammation

Abstract

Leukocytes with cytoplasmic inclusion granules have been found in the synovial fluid of nearly all patients with rheumatoid arthritis. The morphological characteristics are somewhat similar to "glitter cells", but certain differences are noted. Staining characteristics are described. By fracture of such cells from exposure to ultrasonic vibration, rheumatoid factor has been released in detectable amounts in cases of rheumatoid arthritis, but not from cells of non-rheumatoid joint fluids. A working hypothesis for pathogenesis of rheumatoid joint inflammation has been developed. This presupposes the deposit of particulate complexes of rheumatoid factor with gamma globulin in the joint, producing leukocytosis, phagocytosis of the particles, and release of lysozymes producing tissue damage. Additional studies to test this hypothesis are presented in 2 accompanying papers.