Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritis human fluids

Concentration and molecular weight of sodium hyaluronate in synovial fluid from patients with rheumatoid arthritis and other arthropathies

The molecular weight distribution of hyaluronate (HA) in synovial fluid (SF) from 10 patients with rheumatoid arthritis (RA), from six patients with other joint disorders, and from five recently deceased persons without joint affections was investigated by a gel chromatographic procedure. A new and highly specific radioassay was used for determination of the HA concentration in the effluent from the chromatographic column, and this allowed analyses on 0.5 ml or less of untreated synovial fluid. The results confirmed the findings by others that the weight-average molecular weight (Mw) of HA in SF from patients with RA (4.8 X 10(6)) was similar to that in other joint diseases (5.0 X 10(6)) and moderately but significantly (p less than 0.001) lower than that of normal SF (7.0 X 10(6)). Furthermore, the molecular weight distribution of HA in the pathological SF was generally broad and varied considerably between individuals. The HA concentration in the pathological SF varied between 0.17 and 1.32 g/l, which is in accordance with previous reports and considerably lower than that of normal SF. Neither the nature of the arthropathy and the extent of the inflammatory process nor the pharmacological treatment had a tendency to influence the HA concentration in the SF, the mean molecular weight of HA, or its molecular weight distribution. Although the concentration of HA in SF drops in joint disease, the total amount of the polysaccharide is greatly enhanced. Also the amount of high molecular weight polysaccharide (Mw greater than 6 X 10(6)) is in excess in joint disease. The pathological state is therefore characterised not by lack of high molecular weight hyaluronate but by a dilution of it.

Depolymerisation products of hyaluronic acid after exposure to oxygen-derived free radicals

Preparative chromatographic fractions of human umbilical cord hyaluronic acid (HA) of a molecular weight of 10(6) were subjected to graded oxygen-derived free radical (oxy radical) fluxes produced by: (a) the autoxidation of ferrous ions; (b) the action of xanthine oxidase (XO) on hypoxanthine (HX); and (c) by peripheral blood polymorphonuclear leucocytes that had been stimulated by phorbol myristate acetate (PMA). Analysis by gel chromatography of the products obtained with each of the oxy radical generating systems showed polydispersity in size. The smallest molecules detected had a molecular weight of 10(4). This limiting size was not reduced further by exposure to a second oxy radical flux. The relative proportions of large, medium, and small degradation products were established for various levels of oxy radical flux. Consistently a relatively rapid transition from large to small material was seen on Sepharose 2B chromatography, suggesting an ordered element to the breakdown process. Although the decrease in molecular weight after oxy radical exposure was confirmed by analytical ultracentrifugation, this procedure showed that those samples of lowest viscosity did not have the lowest sedimentation values, possibly reflecting oxy radical-induced repolymerisation. If the size and possibly the conformational characteristics of HA are altered, oxy radical exposure might be expected to alter its biological properties.

Relative molecular weight and concentration determination of sodium hyaluronate solutions by gel-exclusion high-performance liquid chromatography

Gel-exclusion chromatography coupled with HPLC instrumentation can be used to determine the molecular weight of highly purified sodium hyaluronate in solution. The method is very reproducible, precise, and rapid, and allows molecular weight determinations up to 2 million to be done in the presence of considerable impurities. This technique offers considerable advantages over traditional light-scattering, sedimentation equilibrium, and viscometry methods for molecular weight determinations, in that HPLC-gel exclusion is rapid and not subject to errors arising from impurities. Simultaneous with molecular weight measurements, sodium hyaluronate concentrations can be determined with a lower range of 0.1 to 0.3 mg/ml dependent upon the sensitivity of the refractive index-detecting system. Unlike the carbazole reaction, this technique is unaffected by low-molecular-weight impurities such as monosaccharides or substances with relative molecular weights less than 18,000.

Changes in the synovia after the intra-articular injection of sodium hyaluronate into normal horse joints and after arthrotomy and experimental cartilage damage

Sodium hyaluronate was injected into normal horse joints and joints that had undergone an arthrotomy and experimental cartilage damage. The elimination half-life for hyaluronic acid in normal joints was found to be approximately 96 h. The injection caused a non-significant increase (42%) in synovial fluid protein concentration and a fall in the intrinsic viscosity of the fluid. In the arthrotomy group the synovial fluid hyaluronic acid concentration fell after surgery but it was unaffected by the injection of sodium hyaluronate. An initial rise in the intrinsic viscosity of the synovial fluid from the arthrotomy group coincided with an increase in protein concentration. However there was no significant difference between the mean intrinsic viscosity or protein concentration in synovia from the control and treated joints at any time after surgery.

Light-scattering study on the influence of link-glycoproteins and lysozyme on the hyaluronate molecular conformation in solution

The influence of link-glycoproteins and mammalian lysozyme on the configuration and size of the hyaluronate molecule in highly diluted solutions under physiological electrolytic and pH conditions was investigated by light-scattering techniques and confirmed by column chromatography, isopycnic flotation, and boundary centrifugation. It was consistently found that link-glycoproteins induce an increase in the basic structural dimensions of the hyaluronate molecule in solution. It was also found that this increase was reversed or prevented under the action of mammalian lysozyme. Changes in configuration of the hyaluronate molecule could be related to its aggregating capacity when the hyaluronate interacts with proteoglycan subunits. It is postulated that link-glycoproteins induce structural changes in the hyaluronate molecule that might improve its aggregating capacity while mammalian lysozyme prevents or regulates such improvement.

Hyaluronic acid-complement interactions--I. Reversible heat-induced anticomplementary activity

The in vitro interaction of hyaluronic acid (HA) with complement (C) classical-pathway activity has been investigated. It was found that native HA, even at a high concn (greater than 3 mg/ml), has a relatively weak anticomplementary activity. However, we report here that native HA can be reversibly altered by heat treatment such that C-inhibitory properties are manifested. We have determined in this study that a potent C-inhibitory activity can be obtained if HA solutions are thermally treated (100 degrees C), and stabilized by prompt freezing with prompt thawing just prior to the interaction with human serum complement. Several investigators have proposed that the intermolecular-associated strands of HA undergo a reversible decoupling upon thermal treatment and this decoupled state of HA can be semi-stabilized by quickly cooling the sample. This heat-treated HA strongly inhibits C1 as well as classical-pathway-mediated C3 conversion. However, if heat-treated HA samples are not stabilized but, rather, slowly cooled after heating or if heated HA samples are snapfrozen and then slowly thawed, the anticomplementary activity is gradually lost. Interestingly, the activity for this same sample can be regenerated by retreatment of the same sample with heat followed by low-temp stabilization, indicating the reversibility of the physical state of HA responsible for the anticomplementary effect. Since no detectable molecular degradation of thermally-treated HA was found, it was assumed that a heat-induced physical transition of HA (decoupled state) was responsible for the C-inhibitory effect.

The lubricating activity of human synovial fluids

The lubricating abilities of human synovial fluids were measured using a rotating cartilage-on-glass apparatus. A total of 247 human fluids were lubrication-tested. Of these, 20 of the 180 knee fluids from patients with degenerative/traumatic joint disease lubricated less well than normal bovine synovial fluid. The remainder of the fluids from the knee and other joints were equivalent to normal bovine synovial fluid in their lubricating properties. The concentrations of hyaluronic acid, protein, and sialic acid and the relative viscosity of 117 human fluid samples were determined, but no relationships between the gross composition and the lubricating abilities were apparent.

Hyaluronic acid concentration in synovial fluid from normal and arthritic joints of horses

A method previously described was used to determine the hyaluronic acid concentration in synovia from normal and arthritic horse joints. The concentration of hyaluronic acid in the synovia from arthritic joints was found to be significantly lower than the concentration in fluid from normal joints.

Molecular weight distribution of hyaluronic acid of human synovial fluid in rheumatic diseases

New methods to isolate and characterize the molecular weight distribution of hyaluronic acid have been applied to human synovial fluids from arthritic patients. Considerable variations in molecular weight distribution were found between the individual fluids. These methods facilitate a detailed characterization of hyaluronic acid--a prerequisite for understanding the role of hyaluronic acid for normal joint function and to evaluate the therapeutic use of local application in joint diseases.

Permeability of rheumatoid and normal human synovium to specific plasma proteins

A method is described for the determination of the permeability of the blood-joint barrier to specific plasma proteins, using the ratio of protein concentration in synovial fluid to that in plasma. The inadequacy of the ratio per se as a direct index of permeability is discussed. Permeabilities are evaluated for the normal and rheumatoid human knee. Permeability increases in the rhematoid knee by approximately 6 times for the rheumatoid knee by approximately 6 times for albumin and over 40 times for macroglobulins. The effect of protein molecular dimensions upon permeability is analyzed. Permeability shows less dependence upon solute dimensions in the rheumatoid knee than in the normal knee, i.e., molecular selectivity is reduced. From these data and synovial morphology, a two-membrane model of the blood-joint barrier is developed. The relative contribution of the component intimal and endothelial layers to the total barrier is found to depend upon solute dimensions.

Immunologic reactions of rabbit anti-Mycoplasma arthritidis serum with in vitro cultivated rat synovial cells

The pathogenesis of the intra-articular, arthritic-inflammatory reaction caused by Mycoplasma arthritidis in susceptible rats and mice is poorly understood. To investigate this problem, synovial cells from normal Sprague-Dawley rats were cultured and studied in vitro. These cells continued to produce hyaluronic acid as measured by viscosity and chemical assays. Normal synovial cells were treated with rabbit serum specimens taken before and after immunization with M. arthritidis. Cytotoxicity assays indicated that the cells were killed in the presence of rabbit anti-M. arthritidis serum but not with preimmunization serum specimens. The anti-M. arthritidis serum was not cytotoxic to monolayer cultures of HEp-2, Vero, or L-cells. Antiserum produced in response to M. fermentans, M. hominis, and M. pulmonis did not produce a cytotoxic effect on the cultured synovial cells. From immunofluorescence studies it was demonstrated that the interactions occurred between the rabbit anti-M. arthritidis serum and synovial cell surface antigens. Extreme precautions were taken to prevent mycoplasmal contamination of rats and the synovial cells in culture. These observations would appear to support previous reports implicating mycoplasmas as biological triggering mechanisms of autoimmune reactions.

Effect of oxygen-derived free radicals on hyaluronic acid

To investigate possible mechanisms of hyaluronic acid depolymerization, superoxide anion and other secondary oxygen-derived free radicals were generated in vitro and allowed to act upon a hyaluronate substrate. Superoxide, generated either enzymatically with xanthine oxidase or by stimulation of polymorphonuclear leukocytes, reduced the viscosity of hyaluronate solutions dramatically while the chromatographic profiles of the glycosaminoglycan shifted toward lower molecular weights. Superoxide-treated hyaluronate also became susceptible to further degradation by beta-N-acetylglucosaminidase A. Experiments with scavengers of various toxic oxygen-derived free radicals clearly implicated these reactants as mediators of hyaluronate depolymerization. Generation of superoxide by leukocytes in vivo may account for the loss of synovial fluid viscosity that accompanies inflammatory joint disease.

Somatomedin activity in synovial fluid from patients with joint diseases

The somatomedin activity in synovial fluids from 50 patients with a variety of joint diseases has been studied and compared with the activity in each of the patient's own serum and a standard reference serum (SRS). The porcine costal cartilage bioassay of Van den Brande and Du Caju (1974a) has been used with the isotopes 3H-thymidine and 35S-sulphate. Synovial fluids from most patients with post-traumatic and post-operative effusions, osteoarthritis and arthritis associated with psoriasis, Reiter's disease, and ankylosing spondylitis stimulated the synthesis of DNA and proteoglycans in cartilage. Synovial fluids from patients with rheumatoid arthritis either had impaired capacity to stimulate DNA synthesis, or they inhibited it; a similar, but less evident pattern was observed for proteoglycan synthesis. Some synovial fluids from patients with miscellaneous synovitides stimulated, while others inhibited cartilage metabolism. It is concluded that the synovial fluid from patients with rheumatoid arthritis and from some patients with miscellaneous synovitides contained an inhibitor(s) to DNA and possibly proteoglycan synthesis. The sera from nearly all the patients stimulated both DNA and proteoglycan synthesis, but the somatomedin potency ratios for serum in terms of SRS were generally less than 1.0. There was a significant inverse correlation between the serum somatomedin potency ratio and the age of the patient.

The molecular dynamics of hyaluronates in solution

The dynamic properties of hyaluronate solutions are discussed with relevance to some problems in sensory physiology (mechanoelectrical transduction), renal physiology, interstitial fluid regulation, and especially to the causes of open-angle glaucoma. With respect to the last problem: as recent biochemical evidence indicates that the hyaloid membrane does not exist, it now seems worthwhile to consider the increase in intraocular pressure present in the eye with glaucoma to be due--at least in the open-angle case--to a change in the specific gravity and hydrophilic nature of the hyaluronic acid in the vitreous body in particular, as well as in the trabecular meshwork. Densimetric experimental evidence indicates that the hyaluronate system could, indeed, produce the pressure changes seen in glaucoma, if intraocular pH changed but slightly. A hypothesis concerning the effect of acetazol amide on intraocular pressure is also presented.

Studies on hyaluronic acid. V. Relationship between the protein content and viscosity of rooster comb dermis hyaluronic acid

Protein accounted for an average of 8.7% w/w of the hyaluronic acid obtained from rooster comb dermis extracts and three types of peptide constituents appeared to be present. A few collagen-like fibers were closely associated with the hyaluronic acid when samples were examined in the electron microscope and collagenase treatment decreased the intrinsic viscosity from 7000-5000 ml/g to 3900-2700 ml/g. The quantities of collagen present, however, were too small to detect chemically with the methods employed. The major peptide consituent was readily separated from the hyaluronic acid by fractionation in a cesium chloride gradient or by treatment with pronase. The viscosity was decreased by the density gradient procedure but not by the pronase digestion. Repeated fractionation in a cesium chloride gradient decreased the intrinsic viscosity still further and a small peptide constituent with a high glycine and serine content remained associated with a hyaluronic acid. The data suggest that an interaction or entanglement with collagen fibers is responsible for the high viscosity of hyaluronic acid in this tissue extract and that the viscosity of purified hyaluronic acid preparations is dependent upon interactions between adjacent polysaccharide chains. Interactions between the major peptide constituent and polysaccharide chains or the small residual peptide component remaining with hyaluronic acid after extensive purification procedures, however, appear to be involved in some organized structure because the presence of the major peptide constituent minimized the decrease in viscosity that occurred when hyaluronic acid samples were lyophilized.

Sulfhydryl-dependent thermal aggregation of human gamma globulin: augmentation by hyaluronic acid

Hyaluronic acid (4 mg/ml) augmented elevenfold the copper-catalyzed (7 muM) thermal (63 degrees C, 2 hours) aggregation of human gamma globulin (2 mg/ml) in 0.075 M phosphate buffer, pH 7.4. Almost no augmentation of aggregation occurred with hyaluronidase-treated hyaluronate. Hyaluronate-augmented copper-catalyzed thermal aggregation was inhibited by L-histidine, gold thiomalate, N-ethylmaleimide, p-chloromercuribenzoic acid, and ethylenediaminetetraacetic acid. Together with previous reports of a decreased blood histidine concentration in rheumatoid arthritis, these studies provide a possible explanation for the affinity of this disease for joints.

Enzymatic degradation of cartilage by dialysed urine of rheumatoid patients

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