Pathways of coagulation activation in situ in rheumatoid synovial tissue

Clin Immunol Immunopathol. 1992 May;63(2):155-62. doi: 10.1016/0090-1229(92)90008-c.


Immunohistochemical techniques were applied to rheumatoid synovium in order to detect components of coagulation and fibrinolysis pathways within these tissues. These techniques revealed an intact coagulation pathway and plasminogen activator inhibitor-2 associated with macrophage-like cells that were present throughout these tissues, especially in subsurface areas. Cell-associated thrombin generation appeared to account for conversion of abundant fibrinogen to fibrin. Occasional macrophage-like cells also stained for urokinase but tissue-type plasminogen activator and plasminogen activator inhibitor-1 were restricted to vascular endothelium. Intense synovial fibrin deposition (with the limited evidence for associated fibrinolysis) may contribute to local inflammation and explain certain clinical features of rheumatoid arthritis. These findings suggest novel treatment hypotheses for this disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Arthritis, Rheumatoid / complications*
  • Blood Coagulation Disorders / etiology*
  • Factor V / analysis
  • Factor VII / analysis
  • Factor X / analysis
  • Factor XIII / analysis
  • Fibrin / analysis
  • Fibrinogen / analysis
  • Humans
  • Immunohistochemistry
  • Macrophages / chemistry
  • Plasminogen Inactivators / analysis
  • Synovial Membrane / pathology*
  • Thromboplastin / analysis


  • Plasminogen Inactivators
  • Factor V
  • Factor VII
  • Factor X
  • Fibrin
  • Fibrinogen
  • Factor XIII
  • Thromboplastin