Infiltration of plasma cells can be a histopathological hallmark of articular synovium with rheumatoid arthritis (RA). A proliferation-inducing
ligand (APRIL) may have key roles in homeostasis and development of B cells, and the differentiation of B cells into plasma
cells. This study was designed to explore the relationships between the infiltrations of plasma cells in synovium and the
synovial fluid levels of APRIL in inflamed peripheral joints of RA. Synovium and synovial fluid were sampled from 21 RA patients
underwent arthroscopic synovectomy for inflamed peripheral joints. The variants of rheumatoid synovium were classified into
the follicular and diffuse synovitis by hematoxylin and eosin staining, and the infiltrations of plasma cells in rheumatoid
synovium were quantified under the light microscope. The synovial fluid levels of APRIL were measured with the enzyme-linked
immunosorbent assay. The mean number of infiltrating plasma cells in synovium and the mean synovial fluid level of APRIL were
significantly increased in follicular synovitis compared with those in diffuse synovitis (
P = 0.009, and
P = 0.018, respectively), and there was a highly positive association between the infiltrations of plasma cells and the synovial
fluid levels of APRIL among all of the RA patients (Rs = 0.776,
P < 0.001). These findings suggest that the local production of APRIL may be associated with the ectopic lymphoid neogenesis
in rheumatoid synovium and may have a role in contributing to the infiltration of plasma cells in synovium within inflamed
peripheral joints of RA.
Keywords Rheumatoid arthritis - Synovium - Plasma cells - Synovial fluid - APRIL - Ectopic lymphoid neogenesis