The levels of metalloproteinases and metalloproteinase inhibitors were measured in rheumatoid synovial fluid. Reliable estimates of total enzyme and inhibitor levels in the synovial fluids were obtained only after hyaluronidase treatment and gel filtration. Three latent metalloproteinases were found which, after activation, degraded collagen, proteoglycan, and gelatin. These enzymes closely resembled the metalloproteinases secreted into connective tissue culture medium. In addition to aZ macroglobulin, an M, 30,000 collagenase inhibitor was detected which closely resembled the tissue inhibitor of metalloproteinase found in tissue culture medium.Rheumatoid arthritis is a disease in which a proliferating synovial pannus degrades cartilage matrix causing joint tissue damage. Little is known of the mechanism by which the cartilage collagen and proteoglycan are lost in vivo, although a number of proteolytic enzymes present in the tissues are capable of digesting these substrates (1). Much of our knowledge of the degradative enzymes secreted by the synovium has come from in vitro tissue and cell culture techniques.Collagenase is likely to be an important enzyme involved in these processes. This metalloproteinase cleaves all 3 cr chains of the triple helical collagen molecule at one point to give characteristic threefourth and one-fourth products. The enzyme is often tis and Rheumatism Council.form August 22, 1983. secreted in a latent form and collagenase activity often cannot be detected in the culture medium of many connective tissues unless the medium is first treated with trypsin (2,3), chaotrophic agents (4-6), or mercurials (7-9). A number of inhibitors of collagenase have been described (10). In addition lo cr2 macroglobulin and p, anticollagenase, a specific collagenase inhibitor has been detected and purified from culture medium (1 1). This inhibitor is thought to play a vital role in the extracellular control of collagenase activity. We have been interested in discovering to what extent these in vitro tissue culture results reflect the situation in vivo, and have therefore examined synovial fluid from rheumatoid joints. It is likely that if cartilage erobion is taking place, the level of either collagenase or inhibitor proteins would change and give an indication of the disease activity. Previous studies (12-18) have shown that both active and latent collagenases are pregent in some rheumatoid synovial fluid. However, no cprrelation was found between the amount of enzyme detected and the disease activity, and the amounts of collagenase inhibitors were not measured in these studies.In this report we have assayed for metalloproteinases and mctalloproteinase inhibitors in rheumatoid synovial fluids taken from patients with active disease.
MATERIALS AND METHODSSynovial fluid, aspirated as part of a therapeutic procedure from knee joints of patients with rheumatoid arthritis, was put into sterile plastic containers and centrifuged at 10,OoOg for 20 minutes at 4°C. The cell-free supernatant synovial fluid was s...