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目的检测类风湿性关节炎患者的软骨和滑膜及血管翳中是否有端粒酶活性表达,以便更深入地了解类风湿性关节炎的发病机制.方法在类风湿性关节炎患者的膝关节手术中获得软骨及沿膜标本,通过原位杂交的方法,检测端粒酶(包括人端粒酶RNA和人端粒酶反转录酶)的活性.结果在多数类风湿性关节炎患者的滑膜组织中检测到端粒酶的表达(6/10,60％),在全部关节软骨(6/6,100％)及血管翳(2/2,100％)中检测到端粒酶的表达,正常关节软骨及滑膜未见端粒酶表达.类风湿性关节炎患者端粒酶的滑膜表达部位主要集中在类风湿性关节炎滑膜细胞层及滑膜内增生的血管内皮细胞,血管翳表达部位集中在紧贴软骨的血管翳细胞,软骨表达部位在病损软骨附近的增生软骨细胞,软骨下骨及软骨内骨髓腔的成骨细胞内也可见高表达.滑膜表达端粒酶阳性的类风湿性关节炎患者都曾经历过关节置换术.结论端粒酶活性可能与类风湿性关节炎发病机制有关,临床上的类风湿性关节炎患者滑膜端粒酶表达阳性可能表示该组织具有很强的侵袭性.“,”Objective To determine whether the presence of telomerase activity among synovial tissue and pannus as well as cartilage tissue could provide insights into the pathogenesis Of rheumatoid arthritis (RA). Methods Synovial and cartilage tissue samples obtained from knee joint during operation in patients with RA were examined for telomerase activity (including human telomerase RNA, i. e., hTR and human telomerase reverse transcriptase, i. e.,hTERT) using the in situ hybridization technique. Results Telomerase activity was detected in over half of the RA synovial tissue(6/10, 60% ), and all articular cartilage(6/6, 100% ) as well as pannus(2/2, 100% ), but was not found in normal synovial and cartilage tissue(0/4). Positive sites of synovial tissue in RA were focused on the lining cells and deep-seated hyperplastic hemangioendotheliocytes. Positive expression in pannus were in the pannocytes next to cartilage, and positive signal in cartilage tissue were in hyperplastic chondrocytes neighboring injuried cartilage. Osteoblasts in marrow cavity from both under-cartilage and inter-cartilage showed strong telomerase expression. In addition, all of the patients with RA and positive telomerase activity had undergone joint replacement operations. Conclusion Telomerase activity in RA synovial tissue and pannus may be involved in the pathogenesis of RA. Cliniclly, the presence of telomerase activity in RA may be an indicator of a more aggressive phenotype.