Synovial immune alterations and biomarkers of arthritis

In different types of inflammatory arthritis including rheumatoid arthritis
(RA), spondyloarthritis, crystal-induced arthritis and some forms of
osteoarthritis, for example, the synovium is hypertrophic and edematous. Since
RA and other arthritides primarily involve the synovium, synovial tissue
analysis provides insight into the pathogenesis of the disease process.
Descriptive studies of the inflamed synovium as well as in vitro functional
analyses of cells obtained from inflamed synovium contribute to an
understanding of the unique events that take place in vivo and complement
experimental animal studies and fundamental studies. Moreover, such studies
allow to identify immune and stromal alterations that are unique to the joint
and can not been found in more accessible tissue compartments such as the
peripheral blood.

- to investigate different cellular, molecular, genetic and epigenetic
pathogenic mechanisms in synovial tissue leading to the various inflammatory
joint diseases
- to investigate these changes in the synovial tissue in relationship to the
duration and different stages of inflammatory joint diseases
- to investigate the relationship between these changes in the synovial tissue
with changes in systemic immunity (ie., blood and SF) in different stages and
forms of inflammatory joint diseases
- to use this knowledge to identify new therapeutic targets in the synovial
tissue in different stages and forms of disease
- to use this knowledge to identify new diagnostic and prognostic markers in
synovial tissue in inflammatory joint diseases.

One center study with the aim to include 300 patients.
single visit study: medical history and medication use en a questionnaire about
disease activity, physical examination, blood drawing, mini-arthroscopy, and if
available, also synovial fluid will be drawn during mini-arthroscopy.

Blood drawing and synovial fluid aspiration has no extra risks since these are
standard care procedures if a patient has an arhtriits. Only extra blood will
be drawn and synovial fluid is not thrown away in this study.
Furthermore a mini-arthroscopy will be done to perform a therapeutic lavage in
a partical inflammatory joint, which is very helpfull for the patient. The
extra thing done for this study is obtaining small biopsies which the patient
will not feel.