Neutrophil trafficking into inflamed joints in patients with rheumatoid arthritis, and the effects of methylprednisolone

✍ Scribed by MB BS(HONS); FRACP Peter P. Youssef; John Cormack; Charles A. Evill; Daryl T. Peter; Peter J. Roberts-Thomson; Michael J. Ahern; Malcolm D. Smith

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 922 KB
• Volume: 39
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780390207

✦ Synopsis

Objective. To investigate the trafficking of circulating blood neutrophils and synovial fluid neutrophils in rheumatoid arthritis (RA) patients and the influence of a 1,000-mg intravenous pulse of methylprednisolone succinate (MP).

Methods. Neutrophils were isolated from the circulation and from the knee synovial compartments of subjects with RA. Circulating neutrophils were labeled with technetium-rn hexametazime (*Tc-HMPAO) and reinjected intravenously. Synovial fluid neutrophils were labeled with indium-111 oxine and reinjected into the knee from which they were isolated. Gamma camera images were obtained at intervals up to 24 hours post MP. Each patient had a baseline study (no MP) and a study in which MP was administered either 4 hours before (2 patients), 10 minutes before (1 patient), or 30 minutes to 1.5 hours after (6 patients) injection of the radiolabeled neutrophils. Subsequent analysis allowed quantitation of the neutrophil uptake into and clearance from the knee as a function of time.

Results. Nine patients who had not received glucocorticoids in the previous 3 months were studied. MP significantly decreased neutrophil ingress in 13 of the 16 knees studied (almost total inhibition in 5 knees), and this occurred within 1.5 hours of MP administration in all except 1 knee. At 24 hours after MP administra-