The concentrations of five normally occurring protease inhibitors in serum and synovial fluid were compared in patients with rheumatoid arthritis, osteoarthrosis, and normal controls. The patients with rheumatoid arthritis showed a significant rise in alpha1-antitrypsin, alpha1-antichymotrypsin, and inter-alpha-trypsin inhibitor (in decreasing order) in serum as well as in synovial fluid. In synovial fluid the inhibitors were present in their native form and bound to hyaluronate. A large molecular protein with immunological specificity of alpha1-antitrypsin, presumably a complex of alpha1-antitrypsin and a protease, could be shown in synovial fluid of all patients with classical and probable rheumatoid arthritis and not in that of the other subjects studied.23Author
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