ELASTASE FROM POLYMORPHONUCLEAR LEUKOCYTE IN ARTICULAR-CARTILAGE AND SYNOVIAL-FLUIDS OF PATIENTS WITH RHEUMATOID-ARTHRITIS

Objective was to study the significance and the mechanism of action of elastase from polymorphonuclear leukocyte (PMN elastase) in patients with rheumatoid arthritis (RA), The experiments conducted consisted of two phases, Firstly, articular cartilage and synovia from 8 patients with RA undergoing total knee replacement were obtained, and the gelat inolytic enzyme activity was extracted with 2M guanidine hydrochloride . The gelatinolytic activity of each tissue was measured to confirm th at the activity was due to PMN elastase by using an antihuman leukocyt e elastase antibody. Secondly, the levels of PMN elastase-al proteinas e inhibitor complex (EIC) in the blood and synovial fluid of 170 patie nts with Ri were measured by immunoassay. The results were as follows: 1, Gelatinolitic activity was shown to be mainly due to PMN elastase, and found to be highest in cartilage and synovia in RA joints, 2, The EIC levels in plasma of RA patients were significantly higher than th ose in gout and osteoarthritis (OA), and the EIC levels increased acco rding to the stage of articular cartilage destruction. Moreover, the E IC levels in synovial fluid of RA patients were higher compared to tho se of OA patients, The activity of PMN elastase was elevated in destru ctive joints of Ri. With the progression of articular cartilage destru ction, EIC levels in plasma of Ri patients increased as well, We sugge st that PMN elastase may play a significant role in RA disease.