Now and then
A method for estimating macromolecular reflection
by human synovium, using measurements of intra-articular half
lives
Department of Physiology,
St George's Hospital Medical School, Cranmer Terrace, Tooting, London
SW17 0RE
Correspondence to: Professor Levick.
Accepted for publication 8 April
1998
Recent studies show that very large macromolecules in
synovial fluid, such as hyaluronan and large proteoglycans, are
partially reflected by the synovial lining during fluid drainage, and
thus selectively retained within the cavity. Size selective molecular reflection is a fundamental property of membranes, and a method for
quantifying the reflective behaviour of human synovium could be of
value in several pathophysiological areas. The method proposed here is
based on the intra-articular half lives of the macromolecule of
interest and of a smaller, easily cleared protein such as albumin. The
key relation is derived from the law of conservation of mass, using
simple algebra. It is found that, when the intra-articular half lives
of albumin and a macromolecular test solute are determined simultaneously, the reflected fraction of the test solute is given by
the complement of the half life ratio. Examples are given. Intra-articular half lives can thus be used to consider such questions as whether immune complexes are significantly reflected by the synovial
surface, how the reflective property changes in arthritides or with
treatment, and how significantly reflection might influence the
intra-articular concentration of large "markers" of joint disease activity.
© 1998 by Annals of the Rheumatic Diseases
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