The hypothesis that haem iron derived from synovial microbleeding has a proinflammatory effect on the synovial membrane was tested by adding autologous whole blood and fractions derived from it to a naturally remitting rat air pouch model of allergic inflammation. The induction of such a subcutaneous air pouch produces a cavity lined by mesenchymal cells comparable to the synovial membrane. Autologous whole blood was found to prolong a low grade inflammatory state, this effect being attributable to a red cell component, most probably haem iron. Whole blood in the absence of an inflammatory stimulus does not have this effect, indicating that the mechanism is one of prolonging or promoting existing allergic inflammation, rather than inducing an inflammatory response.
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