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|Title:||Effect of intra-articular infliximab on synovial membrane pathology in a patient with a seronegative spondyloarthropathy|
|Citation:||Annals of the Rheumatic Diseases, 2008; 67(9):1339-1342|
|Publisher:||British Med Journal Publ Group|
|M J Ahern, D G Campbell, H Weedon, V Papangelis, M D Smith|
|Abstract:||Objective: To demonstrate the efficacy of intra-articular infliximab in a patient with a persistent monarthritis who had previously had two arthroscopic synovectomies with limited success, and to determine the effect of intra-articular infliximab on synovial membrane pathology Method: Arthroscopic synovial biopsy specimens were collected before and after treatment with intra-articular infliximab. The synovial tissue was stained for a range of inflammatory cell subsets, cell adhesion molecules and cytokines using immunohistochemical techniques and quantified using digital image analysis and a semiquantitative scoring method. Results: Clinical improvement in the knee synovitis was seen after the first two intra-articular infliximab treatments, with a sustained clinical remission lasting for more than 12 months after the third treatment. Significant changes in cellular infiltration and expression of cytokines and cell adhesion molecules occurred as a result of treatment with intra-articular infliximab, with a reduction in some but not all cells in the inflammatory infiltrate, as well as a reduction in the expression of cell adhesion molecules (intercellular adhesion molecule-1 and vascular adhesion molecule-1) and production of cytokines (interleukin 1β and tumour necrosis factor α). Conclusion: Intra-articular infliximab administration is a viable treatment for a persistent monarthritis resistant to other treatment options and can successfully modulate the inflammatory milieu within the synovial membrane.|
|Keywords:||Synovial Membrane; Humans; Spondylarthropathies; Synovitis; Antirheumatic Agents; Antibodies, Monoclonal; Biopsy; Injections, Intra-Articular; Adult; Female; Infliximab|
|Appears in Collections:||Orthopaedics and Trauma publications|
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