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June 13, 1966

Rheumatoid Arthritis: Immune Reaction?

JAMA. 1966;196(11):34. doi:10.1001/jama.1966.03100240024009

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Experimental evidence supporting the existing hypothesis that rheumatoid joint inflammation is the result of an immune reaction within the joint space is reported by investigators at the University of Pennsylvania.

The immune hypothesis proposed by investigators at the Arthritis Section, Hospital of the University of Pennsylvania, and the Section of Rheumatology, Hahnemann Medical College, presupposes the deposition in the joint of complexes of some form of gamma globulin and rheumatoid factor.

Enzyme Release  According to this hypothesis, the complex is deposited as a particulate precipitate in the interstitial spaces near the surface of the synovial membrane. Polymorphonuclear leukocytes, attracted from synovial blood vessels by chemotaxis, phagocytose these particles, resulting in leukocytic degeneration and release of lysosomal enzymes.This was proposed by Joseph L. Hollander, MD, at the Hospital of the University of Pennsylvania, and Daniel J. McCarty, MD, of Hahnemann Medical College. It is based upon their observations, made independently,

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