Abstract
Nodules obtained from five patients with classical seropositive rheumatoid arthritis were studied by an immunofluorescence technique using polyclonal antibodies to IgG, IgA, IgM, C3c, and fibrin, and monoclonal antibodies to the terminal (C5b-9) complement complex (reaction with a neoantigen in C9 revealed during activation), DR antigens, T cells, macrophages, and interdigitating cells. In all instances the central necrotic areas stained strongly for fibrin and more weakly for IgG, IgA, IgM, C3, and terminal complement complex. The surrounding palisading cells reacted with antibodies to DR and macrophages. In the peripheral granulomatous tissue most of the lymphocytes reacted with the antibodies to T cells, whereas various amounts of the larger mononuclear cells were stained by antibodies to DR antigens, macrophages, and interdigitating cells. In all instances the walls of some of the smaller vessels in the granulomatous tissue stained for fibrin, C3, and terminal complement complex. Plasma cells were not seen except for scattered IgM cells in one nodule. These results support the view that the palisading cells are derived from macrophages, and indicate that there is vasculitis with activation of C3 and the terminal complement pathway in the granulomatous tissue.
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- Aherne M. J., Bacon P. A., Blake D. R., Gallagher P. J., Jones D. B., Morris C. J., Potter A. R. Immunohistochemical findings in rheumatoid nodules. Virchows Arch A Pathol Anat Histopathol. 1985;407(2):191–202. doi: 10.1007/BF00737076. [DOI] [PubMed] [Google Scholar]
- André P., Lessard R. Les dépôts de complexes immuns dans le nodule rhumatoïde. Ann Dermatol Venereol. 1986;113(2):115–124. [PubMed] [Google Scholar]
- Athanasou N. A., Quinn J., Woods C. G., Mcgee J. O. Immunohistology of rheumatoid nodules and rheumatoid synovium. Ann Rheum Dis. 1988 May;47(5):398–403. doi: 10.1136/ard.47.5.398. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Casali P., Burastero S. E., Nakamura M., Inghirami G., Notkins A. L. Human lymphocytes making rheumatoid factor and antibody to ssDNA belong to Leu-1+ B-cell subset. Science. 1987 Apr 3;236(4797):77–81. doi: 10.1126/science.3105056. [DOI] [PubMed] [Google Scholar]
- Duke O. L., Hobbs S., Panayi G. S., Poulter L. W., Rasker J. J., Janossy G. A combined immunohistological and histochemical analysis of lymphocyte and macrophage subpopulations in the rheumatoid nodule. Clin Exp Immunol. 1984 May;56(2):239–246. [PMC free article] [PubMed] [Google Scholar]
- Fukase M., Koizumi F., Wakaki K. Histopathological analysis of sixteen subcutaneous rheumatoid nodules. Acta Pathol Jpn. 1980 Nov;30(6):871–882. doi: 10.1111/j.1440-1827.1980.tb03277.x. [DOI] [PubMed] [Google Scholar]
- Greenberg A. J. Rheumatoid nodules. J Am Podiatry Assoc. 1982 Feb;72(2):84–88. doi: 10.7547/87507315-72-2-84. [DOI] [PubMed] [Google Scholar]
- Harris E. D., Jr A collagenolytic system produced by primary cultures of rheumatoid nodule tissue. J Clin Invest. 1972 Nov;51(11):2973–2976. doi: 10.1172/JCI107122. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hedfors E., Klareskog L., Lindblad S., Forsum U., Lindahl G. Phenotypic characterization of cells within subcutaneous rheumatoid nodules. Arthritis Rheum. 1983 Nov;26(11):1333–1339. doi: 10.1002/art.1780261105. [DOI] [PubMed] [Google Scholar]
- Kaye B. R., Kaye R. L., Bobrove A. Rheumatoid nodules. Review of the spectrum of associated conditions and proposal of a new classification, with a report of four seronegative cases. Am J Med. 1984 Feb;76(2):279–292. doi: 10.1016/0002-9343(84)90787-3. [DOI] [PubMed] [Google Scholar]
- Miyasaka N., Sato K., Yamamoto K., Goto M., Nishioka K. Immunological and immunohistochemical analysis of rheumatoid nodules. Ann Rheum Dis. 1989 Mar;48(3):220–226. doi: 10.1136/ard.48.3.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Panayi G. S., Wooley P., Batchelor J. R. Genetic basis of rheumatoid disease: HLA antigens, disease manifestations, and toxic reactions to drugs. Br Med J. 1978 Nov 11;2(6148):1326–1328. doi: 10.1136/bmj.2.6148.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paus A. C., Mellbye O. J., Førre O. Immunohistopathologic findings in synovial biopsies before and after synovectomy in patients with chronic inflammatory joint diseases and their relation to clinical evaluation. A prospective study of biopsies taken from areas selected by arthroscopy. Scand J Rheumatol. 1990;19(4):269–279. doi: 10.3109/03009749009102533. [DOI] [PubMed] [Google Scholar]
- Poulter L. W., Campbell D. A., Munro C., Janossy G. Discrimination of human macrophages and dendritic cells by means of monoclonal antibodies. Scand J Immunol. 1986 Sep;24(3):351–357. doi: 10.1111/j.1365-3083.1986.tb02104.x. [DOI] [PubMed] [Google Scholar]
- Rasker J. J., Kuipers F. C. Are rheumatoid nodules caused by vasculitis? A study of 13 early cases. Ann Rheum Dis. 1983 Aug;42(4):384–388. doi: 10.1136/ard.42.4.384. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ziff M. The rheumatoid nodule. Arthritis Rheum. 1990 Jun;33(6):761–767. doi: 10.1002/art.1780330601. [DOI] [PubMed] [Google Scholar]


