低出力レーザー照射のRA滑膜浸潤リンパ球および培養RA滑膜細胞に対する影響

抄録

In rheumatoid arthritis (RA), the histological findings of the irradiated synovial membrane showed flattening of epithelial cells, decreased villous proliferation, narrowed vascular lumen, and reduced infiltration of inflammatory cells compared with nonirradiated synovia. However, the mechanisms of the action of low energy lasers in RA are unclear.
In order to clarify the effects of low energy laser irradiation, the lymphoid cells in the RA synovial membrane were studied using immuno-histology and the cultured synovial cells were studied with an electron microscopy.
The knee joints of 12 RA patients who had been scheduled for arthroplasty were irradiated with a gallium-aluminum-aresenide (Ga-Al-As) laser (790nm wavelength, 10-mW output) two to seven days before the surgical operation, at six points. On the day following the last irradiation, pieces of synovial membrane from the lateral irradiated area and from the medial nonirradiated area as a control were resected during the arthroplasty. The immuno-histological findings of the irradiated synovial membrane based on the peroxidase anti-peroxidase (PAP) method showed decreased CD4 cells in nine cases. A significant difference was seen in Wilcoxon's test (p<0.05). However the findings of the irradiated synovial membrane showed increased CD8 cells in two cases and decreased cells in seven cases. No significant difference was found by Wilcoxon's test on CD8 and CD4/8 of the irradiated synovial membrane. No significant difference in CD4 and CD8 of irradiated peripheral lymphoid cells was revealed by Wilcoxon's test. We noted histological changes (dilation of rER, hypertrophy of Golgi complexes, and decrease in secretions) on the irradiated cultured rheumatoid synovial cells observed by electron microscopy.
These findings suggest that low energy laser irradiation decreased T lymphoid cells presumably through disturbance of cytokine secretion in synovial cells.