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Autometallographic demonstration of gold in rheumatoid synovial tissue
H Graudal1, B Møller-Madsen, G Danscher
1Rheumatism Unit, University of Aarhus, Denmark.
Abstract:
A new autometallographic method for the detection of gold was applied to synovial tissue obtained by synovectomy from 30 patients with chronic arthritis. Granules staining for gold were visualized in biopsies from 26 patients previously or currently treated with gold, but not in biopsies from untreated patients. Location of macrophages was confirmed, and in half the biopsies fibroblast-like cells were also stained. Lymphocytes, plasma cells and interstitial tissue were devoid of gold. Granules were seen after treatment with as small an amount as 85 mg gold sodium aurothiomalate. The amount of gold staining varied between the biopsies and seemed to be related to the amount of gold given. Within individual biopsies, the distribution of gold staining was irregular. It is suggested that there may be at least two targets of chrysotherapy in arthritic joints, and that an influence of gold on the immune system may take place, at least in part, via the macrophages. A relationship between the biopsy findings and the clinical course could not be established.
Insights
A new method detected gold in synovial tissue of arthritis patients treated with gold, primarily in macrophages. This suggests macrophages are a key target for gold therapy in joints.
Area of Science:
- Rheumatology
- Histopathology
- Medical Diagnostics
Background:
- Chronic arthritis, including rheumatoid arthritis, is often treated with gold compounds.
- Understanding the distribution and cellular targets of gold in affected tissues is crucial for optimizing chrysotherapy.
- Previous methods for detecting gold in biological tissues have limitations.
Purpose of the Study:
- To develop and apply a novel autometallographic technique for visualizing gold deposits in synovial tissue.
- To investigate the cellular localization of gold in patients with chronic arthritis undergoing synovectomy.
- To explore potential correlations between gold deposition and treatment history.
Main Methods:
- Synovial tissue samples were obtained from 30 patients undergoing synovectomy for chronic arthritis.
- A new autometallographic staining method was employed to detect gold granules.
- Immunohistochemical staining was used to identify cell types, including macrophages, lymphocytes, and fibroblasts.
Main Results:
- Gold granules were detected in synovial biopsies from 26 out of 30 patients previously or currently treated with gold.
- Gold staining was primarily observed in macrophages, and in some cases, fibroblast-like cells.
- No gold staining was found in biopsies from untreated patients or in lymphocytes, plasma cells, or interstitial tissue.
- Gold deposition was detectable even after administration of a low dose (85 mg) of gold sodium aurothiomalate.
- The amount and distribution of gold staining varied between biopsies and appeared related to the total gold dosage received.
Conclusions:
- The new autometallographic method effectively visualizes gold in synovial tissue.
- Macrophages are a primary cellular target for gold compounds in arthritic joints.
- Fibroblast-like cells may also accumulate gold, suggesting potential secondary targets.
- The findings support the hypothesis that gold's immunomodulatory effects in arthritis may involve macrophages.
- No direct correlation was established between the observed gold deposition patterns and the clinical course of the arthritis.