Synovial tissue research: a state-of-the-art review

Abstract

The synovium is the major target tissue of inflammatory arthritides such as rheumatoid arthritis (RA). The study of synovial tissue has advanced significantly over a number of decades from arthroplasty, blind needle biopsy and more recently facilitated by arthroscopic and ultrasonographic technology that allows easier visualisation and improves the reliability of obtaining synovial biopsies. The potential for study of pathogenesis, patient stratification, discovery of biomarkers and novel targets, as well as validation of therapy, have all been progressed rapidly in the last decade, facilitated by increasingly diverse and sophisticated analytical and technological approaches. In this review we describe clinical and translational developments in the field of synovial tissue research, outlining current and novel investigative technologies, and highlight their application to advance our understanding of the aforegoing imperatives.3

Rheumatoid Arthritis of Knee Joints: MRI–Pathological Correlation

“…The thickened synovium is also characterized by increased vascularity, which is a result of angiogenesis. The angiogenesis is in an immature state, which allows increased leukocyte migration, transforming the synovial tissue into an invading pannus that can cause cartilage and bone destruction. Our findings with regard to the changes in the synovial lining are consistent with those of previous studies.…”

Transcriptional Profiling of Synovial Macrophages Using Minimally Invasive Ultrasound‐Guided Synovial Biopsies in Rheumatoid Arthritis

“…Recent advances in ultrasound technology have opened up a new opportunity for rheumatologists to perform minimally invasive ultrasound-guided synovial tissue biopsies (25). While arthroplasty allows for the collection of large pieces of synovial tissue, using it as a method of obtaining tissue from RA patients for research purposes in the US and in a longitudinal manner is challenging (23,29,41,45,(64)(65)(66)(67). Moreover, the tissue obtained from arthroplasty is usually late stage and may not reflect ongoing active disease, unlike tissue which may be obtained 850 MANDELIN ET AL using ultrasound-guided synovial biopsy.…”

“…Moreover, the tissue obtained from arthroplasty is usually late stage and may not reflect ongoing active disease, unlike tissue which may be obtained 850 MANDELIN ET AL using ultrasound-guided synovial biopsy. The fact that ultrasound-guided synovial biopsies may be performed in the clinic without a surgical suite and require minimal to no recovery time for the patient outweighs the smaller amount of tissue retrieved (23,29,41,45,(64)(65)(66)(67). In fact, in several countries in Europe, this technique is used to obtain synovial tissue for research purposes in a large number of patients without significant complications (34)(35)(36)(38)(39)(40)(68)(69)(70)(71)(72)(73).…”

Review: The Tumor‐Like Phenotype of Rheumatoid Synovium: Molecular Profiling and Prospects for Precision Medicine

“…Rheumatoid FLS exhibit unique pathologic characteristics that include 1) secretion of proinflammatory cytokines, prostanoids, and proangiogenic factors (7,(38)(39)(40), 2) enhanced proliferation and survival, and 3) invasive character via the expression of MMPs and adhesion molecules that bind extracellular components such as integrins and CD44 (41)(42)(43)(44)(45). These features are cell intrinsic, and their persistence in isolated cell culture has prompted a search for causative epigenetic modifications ( Figure 2).…”