title: Collagenase, cathepsin B and cathepsin L gene expression in the synovial membrane of patients with early inflammatory arthritis.
abstract: OBJECTIVE
  To examine the expression of the matrix metalloproteinase, MMP-1, and the cysteine proteases, cathepsin B (CB) and cathepsin L (CL), in the synovial membrane (SM) of patients with early inflammatory arthritis.
  
  
  METHODS
  Samples of SM were obtained by blind needle biopsy or needle arthroscopy from inflamed knees of 28 patients with early inflammatory arthritis (mean disease duration 10.2 months, range 2 weeks-18 months). Sixteen patients had rheumatoid arthritis (RA), nine psoriatic arthritis and there was one each with ankylosing spondylitis, gout and an undifferentiated arthritis. Comparison was made with tissue from two patients with established erosive RA and three normal synovial tissue samples. In situ hybridization was performed using digoxigenin-labelled RNA probes.
  
  
  RESULTS
  MMP-1, CB and CL were expressed in all patients with early arthritis and in established erosive RA, whereas normal synovium showed only scanty expression. The three proteases were prominent in perivascular infiltrates and endothelial cells of early arthritis tissue. MMP-1 was observed primarily in the lining layer, but was also evident in the sublining area. CB and CL were expressed to a lesser extent in the lining layer, and were present mainly in the subintima. The three proteases were not found in lymphoid aggregrates. No differences were observed between the disease categories.
  
  
  CONCLUSIONS
  The detection of MMP-1, CB and CL in the synovium shortly after symptom onset implies that the potential for joint destruction exists at a very early stage in the disease. In addition, the perivascular and endothelial cell expression suggests a role for these proteases in mononuclear cell influx to the inflamed synovium and in angiogenesis.
authors.affiliation: University Department of Rheumatology, St Vincent's Hospital, Dublin, Ireland.
authors.forename: G
authors.initials: G
authors.lastname: Cunnane
authors.forename: O
authors.initials: O
authors.lastname: FitzGerald
authors.forename: K M
authors.initials: KM
authors.lastname: Hummel
authors.forename: R E
authors.initials: RE
authors.lastname: Gay
authors.forename: S
authors.initials: S
authors.lastname: Gay
authors.forename: B
authors.initials: B
authors.lastname: Bresnihan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000201:enzymology* / Q000473:pathology; D015535:Arthritis, Psoriatic / Q000201:enzymology / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000201:enzymology / Q000473:pathology; D002401:Cathepsin B / Q000096:biosynthesis* / Q000235:genetics; D056668:Cathepsin L; D002403:Cathepsins / Q000096:biosynthesis* / Q000235:genetics; D017364:Collagenases / Q000096:biosynthesis* / Q000235:genetics; D003546:Cysteine Endopeptidases; D010450:Endopeptidases; D005260:Female; D015870:Gene Expression; D006073:Gout / Q000201:enzymology / Q000473:pathology; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D020781:Matrix Metalloproteinase 1; D008875:Middle Aged; D012333:RNA, Messenger / Q000096:biosynthesis; D013167:Spondylitis, Ankylosing / Q000201:enzymology / Q000473:pathology; D013583:Synovial Membrane / Q000201:enzymology* / Q000473:pathology
chemical_list: D012333:RNA, Messenger; D002403:Cathepsins; D010450:Endopeptidases; D003546:Cysteine Endopeptidases; D002401:Cathepsin B; C534281:CTSL protein, human; D056668:Cathepsin L; D017364:Collagenases; D020781:Matrix Metalloproteinase 1