Ultrastructure of normal rat synovial membrane

Remobilization does not restore immobilization-induced adhesion of capsule and restricted joint motion in rat knee joints

Joint immobilization, which is used in orthopaedic treatments and observed in bedridden people, usually causes restricted joint motion. Decreased joint motion diminishes activities of daily living and increases burden of nursing-care. The purpose of this study was to clarify the reversibility of immobilization-induced capsular changes and restricted joint motion in rat knee joints. The unilateral knee joints of adult male rats were immobilized with an internal fixator for 1, 2, 4, 8, and 16 weeks as a model of immobilization after surgery or disuse of the joint. After the fixation devices were removed, the rats were allowed to move freely for 16 weeks. Sham-operated rats were used as controls. Sagittal sections at medial midcondylar regions were made and assessed with histological, histomorphometric, and immunohistochemical methods. Joint motion was measured using a custom-made device under x-ray control after removal of the periarticular muscles. In the 1/16-week and 2/16-week immobilization-remobilization (Im-Rm) groups, cord-like structures connecting the superior and inferior portions of the posterior capsule (partial adhesion) were observed without restricted joint motion. In the 4/16-, 8/16-, and 16/16-week Im-Rm groups, global adhesion of the posterior capsule and restricted joint motion were observed. The restricted joint motion was not completely restored after incision of the posterior capsule. These data indicate that immobilization alone causes irreversible capsular changes and arthrogenic restricted joint motion. Besides the joint capsule, other arthrogenic factors such as ligaments might influence the restricted joint motion. Prolonged immobilization over 4 weeks should be avoided to prevent irreversible joint contracture.

Morphology and functional roles of synoviocytes in the joint

The joint capsule exhibits a unique cellular lining in the luminal surface of the synovial membrane. The synovial intimal cells, termed synoviocytes, are believed to be responsible for the production of synovial fluid components, for absorption from the joint cavity, and for blood/synovial fluid exchanges, but their detailed structure and function as well as pathological changes remain unclear. Two types of synoviocytes, macrophagic cells (type A cells) and fibroblast-like cells (type B cells) have been identified. Type A synoviocytes are non-fixed cells that can phagocytose actively cell debris and wastes in the joint cavity, and possess an antigen-presenting ability. These type A cells, derived from blood-borne mononuclear cells, can be considered resident macrophages (tissue macrophages) like hepatic Kupffer cells. Type B synoviocytes are characterized by the rich existence of rough endoplasmic reticulum, and dendritic processes which form a regular network in the luminal surface of the synovial membrane. Their complex three-dimensional architecture was first revealed by our recent scanning electron microscopy of macerated samples. The type B cells, which are proper synoviocytes, are involved in production of specialized matrix constituents including hyaluronan, collagens and fibronectin for the intimal interstitium and synovial fluid. The proliferative potentials of type B cells in loco are much higher than type A cells, although the transformation of subintimal fibroblasts into type B cells can not be excluded. In some mammals, type B cells show features suggesting endocrine and sensory functions, but these are not recognized in other species. The synoviocytes, which form a discontinuous cell layer, develop both fragmented basement membranes around the cells and junctional apparatus such as desmosomes and gap junctions. For an exact understanding of the mechanism of arthritis, we need to establish the morphological background of synoviocytes as well as their functions under normal conditions.

Taxol involution of collagen-induced arthritis: ultrastructural correlation with the inhibition of synovitis and neovascularization

Collagen-induced arthritis (CIA) is an animal model of rheumatoid arthritis (RA) that can be regressed with Taxol (paclitaxel), a chemotherapeutic agent. To identify structural changes that occur with involution, the synovium from naive, untreated CIA, and Taxol-treated CIA rats were evaluated by light microscopy plus transmission and scanning electron microscopy. Analysis included detailed images of vascular networks using polymeric corrosion casts. The CIA synovium was morphologically similar to human RA synovium. In CIA, the integrity of the intimal lining is lost by Type-B synoviocytes becoming highly elongated and polarized toward the joint space, resulting in non-overlapping cellular processes and the elimination of the basal lamina. In addition, the lining expanded from a width of 6-10 microns in naives to 200-250 microns in CIA due primarily to increased numbers of both Type-A and -B synoviocytes and more interstitial matrix. Vascular corrosion casts of CIA synovium illustrated a marked increase in blood vessel volume and an extensive interconnecting vascular architecture; neovascular arrays were observed to project toward the synovial surface. In Taxol-treated CIA, the synoviocyte and neovascular components reverted to the naive synovium morphology, suggesting that this agent might be useful in the therapy of RA.

Equine synovial tendon sheaths and bursae: a transmission electron microscope study

A transmission electron microscope study was undertaken to investigate the details of the synovial tendon sheath and bursal lining in horses. The lining cells appeared to be fibroblasts and were buried in a finely granular ground substance. Generally these cells had poor cytoplasmic organelles, sparse short profiles of rough endoplasmic reticulum (RER), few scattered ribosomes and, occasionally, a poorly developed Golgi complex. However, a few lining cells appeared more active, having pronounced RER with dilated cisternane. The surface of the lining cells, particularly those with dilated RER, had filipodia of different shapes, which in some instances appeared to surround a detached matrix. This feature might indicate that these cells are capable of phagocytosis. In young animals, the lining was more or less akin to that of the adult. However, the lining cells were virtually indistinguishable from the fibroblasts in the subconnective tissue.

An ultrastructural study of age-associated changes in the rabbit synovial membrane

The synovial membranes of 5 young rabbits about 6 weeks old and 5 older rabbits about 3-4 years old were studied with the light and electron microscopes, with a view to discovering any age-associated changes that might occur. Several age-associated changes were noted. These included: (1) a reduction in the overall population of synovial intimal cells; (2) a statistically significant reduction in type B cells and a relative increase in type A cells; (3) the emergence of atrophic cells poorly endowed with organelles; (4) decreased vascularity; and (5) fibrosis.

Absorption of intraarticularly injected horseradish peroxidase in synoviocytes of rat synovial membrane: an ultrastructural-cytochemical study

The ability of type A and type S synoviocytes to absorb horseradish peroxidase (HRP) and the intracellular fate of this tracer were studied by electron microscopic cytochemistry. Different concentrations of HRP (0.1-5 mg/ml) were injected into the left knee joint of rats and at intervals ranging from 1 min to 24 hr after injection the synovial membrane was fixed and incubated for HRP. Type A synoviocytes showed a striking ability to absorb HRP at low concentrations. At 1 and 5 min after injection reaction product was localized in coated pits and coated vesicles (110 nm) as well as in smooth-walled vesicles, vacuoles, and tubules. At 15 min to 4 hr postinjection the lysosomal system became increasingly loaded with reaction product. At 24 hr after injection reaction product had disappeared. At higher concentrations of HRP similar observations were made in the A cells, but reaction product was still apparent in lysosomes at 24 hr postinjection. With respect to type S synoviocytes no reaction product was detected within these cells at any time interval after injection of low concentrations of HRP. However, at 5 min after injection of higher concentrations of HRP reaction product was localized in smooth vesicles and vacuoles mainly restricted to the large cytoplasmic processes facing the joint cavity. At 30 min to 4 hr postinjection the lysosomal system became progressively more loaded with HRP reaction product. At 24 hr after injection reaction product still remained in the lysosomal system. The present findings that type A and type S synoviocytes showed major differences with respect to endocytic capacity and cellular structures involved in absorption of HRP support the interpretation that the A and S cells represent two distinct types of cells and further suggest that endocytosis in these two types of cells serve different functions.

Synovial sarcoma arising in an anatomical bursa

In previous studies, the origin of synovial sarcoma directly from synovium has not been satisfactorily established. This case report describes the light and electron microscopic features of a biphasic synovial sarcoma occurring within the popliteal fossa. At surgery, a cystic mass was identified in relationship to the semitendinosus tendon at the anatomical site of the semitendinosus bursa. The tumour originated from the inner surface of the bursa as multiple papillary projections with no evidence of extension beyond the capsule of the bursa. Portions of the synovial surface were hyperplastic but otherwise normal. The findings indicate that biphasic synovial sarcoma can arise directly from synovium and support the hypothesis of a mesenchymal histogenesis for this tumour.

Ultrastructure of human tendon sheath and synovium: implications for tumor histogenesis

Normal human tendon sheath and synovium were studied by scanning an transmission electron microscopy. The lining cells of the two tissues appear to be identical ultrastructurally. The most superficial cells (B-cells) possess long cytoplasmic extensions that clothe the membrane surface. Intermingled with deeper B-cells are the so-called A-cells, which have similar cytoplasmic features but lack long processes and instead have many filopodia. the frequent occurrence of intermediate forms indicates that the two cells form part of a morphologic spectrum. Comparison with cells of tumors that have been ascribed to synovium or tendon sheath (synovial sarcoma, epithelioid sarcoma, clear cell sarcoma) do not reveal any close similarities that might support a histogenetic relationship.

Overview article: the articular territory of the reticuloendothelial system

It has long been recognized that synovial intimal cells are phagocytic and that they are capable of picking up colloidal or particulate material injected into the circulation. Hence they have been described as the "articular territory of the reticuloendothelial system." Ultrastructural studies have added a wealth new knowledge and details about the remarkable endocytotic powers of synovial cells. It has been shown that they can endocytose not only small particulate substances like colloidal iron, colloidal gold, and thorotrast but also relatively large objects like masses of fibrin and entire erythrocytes. Controversy has arisen as to whether it is the Type A or Type B cell that is the main scavenger of the joint. Evidence will be presented to show that this is a somewhat fictitious controversy and that these are not distinct and different races of cells with different functions but merely cells whose differences in morphology reflects the function they are performing at a given moment.

Cellular junctions in normal and inflammatory human synovial membrane revealed by tannic acid and freeze fracture

Cellular junctions between synovial cells and endothelial cells of the microvasculature were examined in 10 normal and 20 inflammatory human synovial membranes by means of tannic acid and freeze fracture, Gap junctions and desmosomes predominated on synovial cells, and tight junctions in the microvasculature. Comparison between normal and inflammatory synovial membranes did not demonstrate changes in cellular contacts that might be caused by inflammation.

A mechanism of formation of desmosome-like structures between synovial intimal cells

Desmosomes or desmosome-like structures do not occur between normal synovial cells but such structures do develop between the synovial cells in cases of traumatic arthritis, rheumatoid arthritis and villonodular synovitis. Morphological evidence is presented suggesting that such structures develop as a result of the interaction of fibrin trapped between synovial cells and the plasmamembrane of these cells.

B-cells of the synovial membrane. I. A comparative ultrastructural study in some mammals

Comparative ultrastructural study of the B-cells in the intimal layer of the synovial membrane in mouse, rat, rabbit, guinea-pig and man clearly distinguishes these cells from both the histiocytic A-cells (macrophage-like cells) and the fibroblasts. In addition to the marked development of the rough endoplasmic reticulum and Golgi apparatus, typical dense secretory vesicles apparently of Golgi origin are always found in mouse B-cells and frequently in those of the rat. These secretory characteristics clearly relate these cells to glandular cells engaged in polypeptidic secretion. The variations in the other species studied concern only the figuration of secretory material. Thus, the B-cells appear to constitute a category of secretory cells specific to the synovial membrane, but the function of which has yet to be determined.

[A contribution to the origin of ganglia. A study of light-, immunofluorescence-, and electronmicroscopic changes (author's transl)]

10 ganglia were studied by means of light and electrone microscope and with immunfluorescence methods. The light microscopic findings in the wall of a ganglion resemble on developing hygroma. The mesenchymal cells ultrastructurally show differentiation to synovia-like cells, either surrounding the ganglion in the connective tissue wall or lining the cavity. The development of synovial tissue from undifferentiated mesenchymal cells is due to the typical mechanical stimulus affecting joints.

Morphological evidence of a polypeptide-like secretory function of the B cells in the mouse synovial membrane

In the synovial membrane of the mouse, morphological features associated with active secretion are unusually well developed in cells immediately subjacent to the lining layer (in the position of B cells), comparable to those of cells known to elaborate polypeptides.

Epithelioid sarcoma: ultrastructural similarity to nodular synovitis

The ultrastructure of nodular synovitis of the knee and epithelioid sarcoma of the hand are compared. Both lesions show a similar pattern of light and dark cells having filopodia and microvilli, an outer coat of finely granular matrix without well defined basal laminae, maculae adherentes and attachment sites, pinocytotic vesicles, cytoplasmic filaments and complex nuclear invaginations. These similarities suggest a common histogenesis and support the concept that the epithelioid sarcoma is derived from synovioblastic mesenchyme.

Cellular contacts in the synovial membrane of the cat and the rabbit: an ultrastructural study

Regularly, four different types of cellular contacts are found in synovial folds and villi of the cobital joint of the cat (interdigitations, desmosomes, intermediate junctions, gap junctions). The same types of contact--with the exception of intermediate junctions--occur sporadically also in synovial fat folds of the knee joint of the rabbit. In both species, hemidesmosomes and discontinuous basement membranes are seen in the synovial lining layer. Cellular contacts predominate between A-cells and cells of the intermediate type, hemidesmosomes and incomplete basement membranes predominate in intermediate cells and B-cells. The latter are rare in A-cells. The importance of such contacts for mechanical, metabolic and electrical interactions of cellular elements in the synovial membrane is discussed. No unanimous concept as to their function can be advanced at present.

Immunohistological studies, with anti-connective tissue and anti-immunoglobulin antisera, of the skin in lupus erythematosus and scleroderma

Skin lesions from six patients with systemic lupus erythematosus, five patients with discoid lupus erythematosus, twelve patients with systemic sclerosis, five patients with localized morphoea and twenty controls were examined by immunohistological techniques using fluorescein-labelled anti-human IgG, anti-human C3 and anti-human renal glomerulus antisera. The major immunohistological changes in systemic sclerosis and in localized morphoea consisted of foci of intercollagenous staining for connective tissue antigens in the reticular layer of the dermis. It is suggested that these findings indicate collagen neogenesis. In lupus erythematosus the major changes occur in the dermo-epidermal junction and consist of deposits of IgG and C3 and thickening and disruption of the membrane as demonstrated by the use of heterologous sera containing antibasement membrane antibodies. Immunohistological techniques are useful in the diagnostic differentiation between scleroderma and lupus erythematosus.