Role of endothelium in chronic inflammation

The chronic inflammatory reaction that occurs in the sublining layer of the rheumatoid synovial membrane has the features of a cellular immune response. The response is of sufficient intensity and chronicity to result in the synthesis of large amounts of antibody. The amounts of antibody and the proportions of the immunoglobulin classes of antibody synthesized are similar to those produced by normal lymphoid tissue (Smiley et al.,1968). The pattern of distribution of the mononuclear cells in rheumatoid synovial tissue into lymphocyte-rich areas and into transitional areas containing plasma cells and macrophages also has similarities to that in lymphoid tissue, in which lymphocyte-rich areas compose the paracortical region of the node, and antibody-producing cells with macrophages are present in the follicular and medullary regions.