The Action of Hydrocortisone in Synovial Inflammation 12

Mucopolysaccharides in synovial fluid. Effect of aspirin and indomethacin on hyaluronic acid.

“…Corticosteroids increase polymerization of hyaluronic acid (Barker and others, 1963), and this probably explains their effect in increasing the relative, intrinsic, and anomalous viscosity of synovial fluid by either local or systemic administration (Bauer, Giansiracusa, and Ropes, 1950;Sundblad, Egelius, and Jonsson, 1954;Nanto and Seppala, 1962). Other explanations of their effect are that the less polymerized fraction is eliminated from the joint (Nantb and Seppala, 1962) or that they have a direct effect on the synthesis of hyaluronic acid in synovial tissue (Jessar, Ganzell, and Ragan, 1953;Sundblad and others, 1954). However, it is not known whether corticosteroids reduce the production of imperfectly-formed hyaluronic acid or decrease the rate of enzymic breakdown of normally-formed hyaluronic acid.…”

Measurement and Interpretation of Synovial Fluid Viscosities

“…An improvement in the viscous properties of fluids taken at intervals from a pathological joint does not necessarily indicate that all the tissues are recovering. Nevertheless, there is reason to believe that it reflects a lessening of inflammatory processes (Jessar, Ganzell, and Ragan, 1953). Taken in conjunction with other tests, such as those of Fletcher, Jacobs, Rose, Hess, and Markham (1954), and with the clinical picture, viscosity determinations can provide a valuable objective guide to the effect of any new drug that is being tested.…”

Rheumatoid Pericarditis

“…Certainly the pericarditis of systemic lupus erythematosus is more frequently recognized during life, for Jessar et al (1953) diagnosed it in 23%, Dubois (1953) in 43.5%, and Harvey et al (1954) in 48% of patients. By contrast, the reports of pericarditis complicating rheumatoid arthritis are mostly single case reports, though Goslings (1958) and Tarpley (1961) have presented several cases.…”

“…However, there is no strong reason why the presence of pericarditis should suggest systemic lupus erythematosus rather than rheumatoid arthritis, for post-mortem studies have shown pericarditis in from 47 to 80% of cases of systemic lupus erythematosus (Griffin and Vural, 1951;Dubois, 1953;Jessar et al, 1953), compared with the still considerable proportion of 40 to 50% of rheumatoid arthritic patients reported by most authors (for example, Young and Schwedel, 1944;Bauer and Clark, 1948). Certainly the pericarditis of systemic lupus erythematosus is more frequently recognized during life, for Jessar et al (1953) diagnosed it in 23%, Dubois (1953) in 43.5%, and Harvey et al (1954) in 48% of patients.…”