Antibodies to synovial-derived cells in patients undergoing artificial prosthesis implants.

In this preliminary study, the authors have found cytotoxic complement-dependent synovial antibodies in the serum of patients undergoing prosthesis implantation; these were particularly evident in those patients undergoing revision surgery. In order to demonstrate the synovial antibodies, it was necessary that the authors modify the method they had previously used in their studies of cytotoxic lung and kidney antibodies. While conventional trypsinization dispersion produced synovial target cells that would not react in the test system, mechanical dispersion successfully produced target cells sensitive to complement-dependent cytotoxic antibodies. In this study, synovial antibodies reacted similarly to cells derived from the synovium of different individuals, but they did not react to cells derived from tissues other than synovium. This tissue specificity was confirmed by absorption studies that indicated the synovial antibodies to be organ specific. Whether these cytotoxic synovial antibodies can be predictive of the impending loss of an artificial prosthesis, or somehow be directly involved in the failure mechanism of that prosthesis, will require additional studies.