MICROSCOPIC MEASUREMENT OF CELLULAR INFILTRATION IN THE RHEUMATOID-ARTHRITIS SYNOVIAL-MEMBRANE - A COMPARISON OF SEMIQUANTITATIVE AND QUANTITATIVE-ANALYSIS

Microscopic measurement of inflammation in synovial tissue may be impo rtant in studies of clinical status, prognosis and response to treatme nt. The aim of this study was to compare quantitative microscopic anal ysis of inflammation with a semiquantitative grading system in rheumat oid arthritis (RA) synovial membrane. Knee synovial membrane samples f rom 16 patients with RA, including paired samples taken before and aft er treatment in nine patients, were immunostained with anti-CD68 and a nti-CD3 monoclonal antibodies using standard techniques. The intensity of macrophage and T-lymphocyte infiltration was measured both by quan titative and semiquantitative techniques, and the results were compare d. In a cross-sectional comparison, both methods correlated significan tly for lining layer macrophage infiltration, as well as sublining lay er macrophage and T-cell infiltration. However, in some patients demon strating a clinical response to treatment, semiquantitative analysis l acked sensitivity to biologically relevant changes in mononuclear cell infiltration. These observations have important implications for futu re studies of therapeutic modalities.