MOBILIZATION OF FIBRINOLYTIC ENZYMES IN SYNOVIAL-FLUID AND PLASMA OF RHEUMATOID-ARTHRITIS AND SPONDYLOARTHROPATHY AND THEIR RELATION TO RADIOLOGICAL DESTRUCTION

Objective. To study the role of fibrinolytic enzymes in inflammatory j oint diseases with different types of joint destruction. Methods, Conc entrations of the plasminogen activators pro-urokinase, tissue plasmin ogen activator, plasminogen activator inhibitors 1 and 2 (PAI-I and PA I-2), plasminogen, and fibrin split product D-dimer in synovial fluid (SF) and blood plasma of 29 patients with rheumatoid arthritis (RA) we re compared with the concentrations of 18 patients with spondyloarthro pathy (SpA). Levels of the fibrinolytic components were also related t o radiological destruction assessed using the Larsen grading system. R esults, Patients with RA had significantly higher PAI-1 antigen levels and PAI-I activity in SF than patients with SpA. Plasma levels of PAI -1 antigen and D-dimer were significantly higher in RA than in SpA. Th ere was also a tendency of lower tPA activities in SF and plasma of pa tients with RA. Joint destruction correlated significantly with increa sing PAI-1 antigen and with decreasing plasminogen in SF when results from all patients were pooled. A significant negative correlation betw een plasma PAI-2 antigen and Larsen grade was also found. Conclusion, Our results indicate a possible association between joint destruction and mobilization of fibrinolytic enzymes in SF.