Lysozyme in rheumatic diseases

Lactoferrin and lysozyme in arthritic exudates

Lactoferrin (LF) has been assayed by radioimmunoassay in plasma and arthritic exudates and compared with lysozyme (LZ) levels and leukocyte counts. The mean LF concentration in 38 rheumatoid arthritis (RA) exudates was 9.1 mg/l (range 0.02-39.2). In 30 non-RA exudates LF was 3.3 mg/l (range 0.01-14.6). The corresponding LZ levels were 7.4 mg/l (range 2.5-18.5) in RA and 4.7 (range 1.0-12.5) in non-RA fluids. Exudate/plasma ratios were much higher for LF than for LZ and higher in RA than in non-RA exudates, whereas leukocyte counts did not differ. The LF/leukocyte count ratio was significantly higher in RA than in the non-RA group. The data suggest a more prominent release of neutrophilic granulocyte components in RA than in non-RA arthritis.

Soluble adhesion molecules, cytokines and cellular markers in serum in patients with acute infections

The aim of this study was to evaluate the diagnostic capacity of a number of blood components such as soluble adhesion molecules, interleukin-6 (IL-6), myeloperoxidase (MPO) and lysozyme in the distinction of acute bacterial and viral infections. Blood was taken from 115 acutely infected patients at admission before any treatment and in some cases on several consecutive days. 35 of the patients had a definite viral cause for their infection and 66 a bacterial cause. All variables were raised in patients with acute bacterial infections. Soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, lysozyme and MPO were also raised in acute viral infections, but for sE-selectin and MPO less so than in bacterial infections. Evaluation of the diagnostic power showed that for MPO and IL-6 at cut-offs of 1300 microg/l and 100 ng/l, respectively, the positive predictive value was 97% and 100% and the negative predictive value 78% and 76%, respectively, in the classification of acute bacterial infections. In the distinction between viral or bacterial causes of acute infections in otherwise healthy subjects serum measurements of MPO and IL-6 are valuable tools and should be considered as diagnostic aids in the routine setting. The soluble adhesion molecules did not offer any further information in this respect.

Quantification of hen egg white lysozyme in cartilage by an enzyme-linked immunosorbent assay

We have developed an enzyme-linked immunosorbent assay (ELISA) with an inhibition step to quantify hen egg white lysozyme (HEWL) on a weight basis. The assay is relatively insensitive to changes in ionic strength or pH. Quantification is not affected by the presence or large amounts of mammalian lysozymes or inhibitors of enzymatic activity such as soluble chitin oligomers. We used this ELISA to show that the HEWL content of chick cartilages increases progressively between days 14 and 18 of embryonic life. The maturation-related increase does not appear to be the result of increased synthesis by the chondrocytes for the latter did not synthesize detectable amounts of lysozyme in vitro. Evidence was obtained to suggest that most, if not all, the lysozyme in cartilage is derived from the surrounding fluids which come in contact with the matrix.

Determination of lysozyme activity by fluorescence polarization in rheumatoid synovial fluids and release of lysozyme from polymorphonuclear leukocytes by chemotactic factors

A new method for the measurement of lysozyme activity, which is rapid, quantitative and sensitive, was established and applied to clinical material obtained from arthritis patients. The method is based on fluorescence polarization with the use of fluorescein isothiocyanate-labeled peptidoglycan. Using this method, we found that the synovial fluids obtained from rheumatoid arthritis contained more lysozyme activity than similar samples from osteoarthritis patients (P less than 0.001). Furthermore, we found that chemotactic factors and lysozyme-depleted rheumatoid synovial fluids could induce the release of lysozyme from human polymorphonuclear leukocytes in vitro. It is therefore suggested that lysozyme present in rheumatoid synovial fluids may derive in part from polymorphonuclear leukocytes and the action of chemotactic factor(s) within the fluids.

Beta-thromboglobulin in inflammatory synovial fluid

Activated platelets release substances which potentially can contribute to joint lesions in inflammatory arthritides. To elucidate a possible participation of platelets in inflammatory joint reactions, the concentrations of the platelet protein beta-thromboglobulin (beta-TG) were measured in 90 inflammatory synovial fluids. Seven percent of the patients with rheumatoid arthritis and none of the patients with other inflammatory joint diseases (e.g., Reiter's disease, reactive or crystal arthritides) had beta-TG concentrations in synovial fluid exceeding the upper normal range of plasma beta-TG. The absent or very modest signs of local platelet activation were contrasted by the pronounced neutrophilic and monocytic activation, as assessed by the measurements of some granule proteins: lactoferrin, myeloperoxidase, lysozyme, and ferritin. No correlation was found between these inflammatory cell markers and beta-TG. A positive correlation (p less than 0.001) was noted between beta-TG and beta 2-microglobulin, which appeared in particularly high amounts in rheumatoid arthritis. This correlation may reflect a disturbed permeability of synovial membrane for LMW proteins or a related activation of platelets and lymphocytes. The present results do not give any evidence of platelet activation playing a major role in proliferative or destructive processes in arthritis.

Connective tissue lysozyme in health and disease

As the lysozyme story continues to unfold, rheumatic disease is one area where the study of this fascinating protein will be most important. The special biochemical features of lysozyme--its hexosaminidase function, its ability to bring about transglycosylation, its homology to alpha-lactalbumin, and its cationic nature--suggest that the connective tissues may prove to be the key to the understanding of the function of lysozyme. As methods for its accurate measurement become standardized, better data on the activity of the enzyme in various tissues and body fluids, in both health and disease, will be forthcoming. As additional studies are done to ascertain which of the hypothetical functions attributed to lysozyme are of significance in vivo, it will be the student of the connective tissues and the diseases thereof who can be expected to profit most from an udnerstanding of the role of lysozyme in mammalian biology.