Synovial membrane in rheumatoid arthritis: Determination of glycosaminoglycans and age-dependent correlations

From 16 synovial membranes of patients with rheumatoid arthritis morphological parameters as well as the GAG distribution pattern have been determined using 2 methods each. The results were checked by discriminant and regression analysis:

The total GAG concentration of the synovialis was significantly correlated with the sum of the parameters “fibrin in organization”, “granulocytes” nad “necroses” (acute activity).

A highly significant correlation between the age of patients and the severity of chronic morphological alterations (basic activity, especially proliferation) was found.

The percentage of CS plus DS was positively correlated with the age of patients as well as with the basic activity of the disease, especially with the proliferation. — Contrary to this, HA was significantly decreased when related to the “chronic” parameters.

No correlation could be demonstrated between the GAG components and criteria of the acute activity.

The evaluating system of Stiehl and Geiler is to be preferred for obtaining morphologic-biochemical correlations.

Furthermore, a diagram is proposed demonstrating the cumulative progression of rheumatoid arthritis in the synovialis as related to the GAG pattern. Its combination with morphological data (scars, proliferation, exudation) may help to describe the development of the disease more acurately.