Abstract
Publisher Summary Acquisition of experimental data pertinent to the human disease is made more difficult by the rather sketchy and incomplete knowledge available of the pathophysiology of this disease. Long-term retention of antigen in avascular collagenous structures depends on its trapping in the form of insoluble immune complexes maintained in antibody excess by the high antibody concentration found in the joint cavity. Such an environment is provided in part by the active local synthesis of antibody. This feature may be of paramount importance for the retention of antigen, because both antigen and antibody are free to diffuse out of the tissue when strong chaotropic solutions or antigen in excess are used to solubilize the sequestered immune complexes, suggesting that they are retained within the collagen fiber meshwork mainly on the basis of their size and poor solubility. Quantitation of the cellular exudate within the joint cavity provides a simple and objective method of assessing the magnitude of the inflammatory response. Soon after the initial acute Arthus reaction abates, the synovial cavity may contain very small amounts of synovial fluid, precluding direct-cell quantitation.
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