Isozymes of Lactic Dehydrogenase; Their Alterations in Arthritic Synovial Fluid and Sera*

Vesell, Elliot S.; Osterland, Kirk C.; Bearn, Alexander G.; Kunkel, Henry G.

doi:10.1172/jci104659

Cited by 51 publications

(9 citation statements)

References 26 publications

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“…The finding that the highest intracellular enzyme activities were seen in joints of patients with "classical" RA and the lowest in those with osteoarthrosis agrees with many other studies (Jacox and Feldmahn, 1955;Vesell, Osterland, Beam, and Kunkel, 1962;Quatrini and Pignataro, 1962;West, Poske, Black, Pilz, and Zimmerman, 1963;Lehman, Kream, and Brogna, 1964;Caygill and Pitkeathly, 1966).…”

Section: Discussionsupporting

confidence: 90%

Intracellular enzymes and kinin enzymes in synovial fluid in joint diseases. Origin and relation to disease category.

Jasani¹,

Katori²,

Lewis³

1969

Annals of the Rheumatic Diseases

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Section: Discussionsupporting

confidence: 90%

Intracellular enzymes and kinin enzymes in synovial fluid in joint diseases. Origin and relation to disease category.

Jasani¹,

Katori²,

Lewis³

1969

Annals of the Rheumatic Diseases

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“…Indeed, Vesell noted that the elevation in LDH activity was not proportional to the number of white blood cells observed. 20 The finding of a normal serum level of enzyme and elevated synovial fluid There is the possibility that species specific isozyme patterns may exist as well as organ specific ones. Thus the pattern obtained from synovial tissue (and perhaps reflected in' synovial fluid isozymes) might and, indeed, does differ from that obtained from skeletal muscle.…”

Section: Discussionmentioning

confidence: 99%

Lactic dehydrogenase (LDH) and transaminase (GOT) activity of synovial fluid and serum in rheumatic disease states, with a note on synovial fluid LDH isozymes

Cohen

1964

Arthritis & Rheumatism

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Lactic acid dehydrogenase (LDH) and glutamic-oxalacetic transaminase determinations were carried out on the serums and synovial fluids of patients with a variety of rheumatic diseases. The LDH activity of the synovial fluid was elevated in patients with rheumatoid arthritis, infectious arthritis and gout, but normal in the fluids of patients with degenerative joint disease. Transaminase activity was normal in both serum and synovial fluid in all cases. Starch gel zymograms of LDH showed qualitatively increased amounts of the isozyme LDH 5 in the pathological synovial fluids. S. COHENDeterminationes del dehydrogenase de acido lactic e de transaminase glutamicoxaloacetic esseva executate in le seros e le liquidos synovial de patientes con un varietate de morbos rheumatic. Le activate de dehydrogenase lactic del liquido synovial esseva elevate in patientes con arthritis rheumatoidee, con arthritis infectiose, e con gutta, sed ill0 esseva normal in le liquido synovial de patientes con morbo degenerative del articulationes. Le activitate de transaminase glutamic-oxaloacetic esseva normal in omne casos tanto in le liquido synovial como etiam in le sero del sanguine. Zymogrammas a gel de amylo pro dehydrogenase de acido lactic monstrava augmentos qualitative del quantitates del isozyma 5 de hydrogenase de acido lactic.

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“…It could also be of interest to look for any enzyme contribution originating in the lining walls of the synovia. Vesell, Osterland, Bearn, and Kunkel (1962) and especially Cohen (1964), who studied the LDH activity of synovial fluid in rheumatic disease states, reported that total synovial fluid LDH was raised in patients with inflammatory articular disease, and found marked rises of LDH5 in total synovial fluids of rheumatoid, gouty, and infected joints. They only found a minimal increase of LDH5 in fluids from cases of degenerative joint disease.…”

mentioning

confidence: 99%

Lactate dehydrogenase in synovial fluid diagnostic evaluation of total activity and isoenzyme patterns.

Em¹,

Wieme²

1968

Annals of the Rheumatic Diseases

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The work of Ropes and Bauer (1953) has focused attention on the analysis of synovial fluid in the differential diagnosis of joint effusion. White blood cell total and differential counts, glucose assay, and mucin precipitation tests have thus all been applied to the distinction of non-inflammatory, mild inflammatory, severe inflammatory, and infectious effusions. These analyses do not, however, indicate the true origin of the effusion, and we have carried out this investigation to find out whether differential assay of lactate dehydrogenase (LDH) isoenzymes could yield more specific information.It is known that the percentage of polymorphonuclear cells (PMN) and of lymphocytes is different in non-inflammatory, inflammatory, and infectious effusions. Recent studies (Dioguardi, Agostoni, Fiorelli, and Lomanto, 1963;Bottomley, Locke, and Ingram, 1966;Hule, 1967) indicate that polymorphonuclear cells and lymphocytes have different LDH isoenzyme patterns. One may thus expect to find LDH shifts in parallel with the type of the cellular material. It could also be of interest to look for any enzyme contribution originating in the lining walls of the synovia.Vesell, Osterland, Bearn, and Kunkel (1962) and especially Cohen (1964), who studied the LDH activity of synovial fluid in rheumatic disease states, reported that total synovial fluid LDH was raised in patients with inflammatory articular disease, and found marked rises of LDH5 in total synovial fluids of rheumatoid, gouty, and infected joints. They only found a minimal increase of LDH5 in fluids from cases of degenerative joint disease. Although these observations suggest that this type of analysis will be of little diagnostic value, one must remember that Vesell and others (1962) studied only a limited number of cases, including several of ill-defined aetiology. Cohen (1964) used LDH isoenzyme differentiation only as a complement to other enzyme studies; he confined himself to a visual interpretation of the LDH patterns in a relatively small number of cases.We therefore felt that interesting results might be obtained by applying a quantitative technique of LDH differentiation to a large number of cases of well-established aetiology.We have also determined LDH isoenzyme patterns separately on cell-free fluid and on cellular material after ultrasonic disintegration. MethodsSynovial fluids were aspirated with sterile precautions from different joints (knee, elbow, hip, ankle) without using local anesthetics. In supplement to the analyses mentioned, the fluids were also submitted to bacteriological culture and to differential count of the white blood cells.Before the determination of total LDH activity and analysis of the LDH patterns, a constant amount of the synovial fluid (10 ml.) was centrifuged at 50,000 G. and 100 C. temperature for 30 min. In this way a clear cell-free supernatant and a cellular sediment were obtained. The supernatant was used as such. The sediment was washed three times with saline and finally resuspended in exactly 5 ml. saline. This suspensio...

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Isozymes of Lactic Dehydrogenase; Their Alterations in Arthritic Synovial Fluid and Sera*

Cited by 51 publications

References 26 publications

Intracellular enzymes and kinin enzymes in synovial fluid in joint diseases. Origin and relation to disease category.

Intracellular enzymes and kinin enzymes in synovial fluid in joint diseases. Origin and relation to disease category.

Lactic dehydrogenase (LDH) and transaminase (GOT) activity of synovial fluid and serum in rheumatic disease states, with a note on synovial fluid LDH isozymes

Lactate dehydrogenase in synovial fluid diagnostic evaluation of total activity and isoenzyme patterns.

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