Both purified hyaluronic acid (HA) and bovine synovial fluid react with OC1-, the major oxidant produced by the myeloperoxidase (MPO)/H202/CI-system, resulting in a decrease in their specific viscosity. This reaction is inhibited in the presence of excess methionine. H202 alone decreases the viscosity of HA, presumably by the Fenton reaction, in the absence (but not in the presence) of the iron chelator, diethyltriaminepentacetic acid (DETAPAC). In the presence of DETAPAC, incubation of HA with the complete MPO/ H202/CI-system lowered the viscosity of HA. Analysis of 3H-HA exposed to OC1-by gel filtration chromatography indicated that cleavage of HA occurred only at higher OCI-concentrations. We suggest that the reduction in viscosity of HA by the MPO/H202/CI-system may be due to a combination of oxidative cleavage and changes in the conformation of the molecule. We speculate that the changes in the molecular size of rheumatoid synovial fluid HA may be due to the action of the neutrophil MPO/H202/CI-system. Submitted for publication June 20, 1988; accepted in revised form November 7, 1988. sible for the viscosity of SF, and it has been argued that it is also responsible for the lubricating properties of SF (1,2). In inflammatory arthritides, such as rheumatoid arthritis (RA), SF loses viscosity (3,4), and depolymerization of the HA molecule has been suggested as the cause (5). The loss of HA viscosity within the arthritic joint is accompanied by the infiltration of large numbers of polymorphonuclear leukocytes (PMNs) into the joint space. These phagocytic cells are known to release oxygen free radicals and their products (e.g., O,, HO-, H,02) during the "respiratory burst,'' in addition to numerous proteolytic and microbicidal enzymes (elastase, cathepsin G, lysozyme, and myeloperoxidase [MPO]) into either the phagosome or extracellular space during degranulation.
Hyaluronic acid (HA) is the major macromolecular component of synovial fluid (SF).Because no hyaluronidase activity has been identified in neutrophils, synovium, pathologic SF, or articular cartilage (3), an alternative mechanism for the loss of SF viscosity must exist. Because SF contains little, if any, of the 0, and H,02 scavenging enzymes (superoxide dismutase [SOD] or catalase, respectively [6]), the present hypothesis is that SF HA is degraded by the extremely reactive hydroxyl radical (HO.) produced via the 0; radical-driven Fenton reaction after release of 0; from "activated" PMNs (33-7). This reaction requires not only sources of H202 and a suitable reductant, such as O;, but also accessible transition metal ions (e.g., Fe3+). Recently, low levels of bleomycin-detectable Fe3+ bound to an asyet-unidentified SF protein were found in -40% of RA patient SFs (8).An alternative mechanism by which "activated" PMNs may decrease SF viscosity during RA involves the heme enzyme MPO. Any H202 released during the "respiratory burst" could be metabolized,
462BAKER ET AL within the extracellular space, by MPO simultaneously expelled from azurophil granu...