自体血清关节腔内注射对骨性关节炎软骨细胞凋亡的实验研究

目的:研究自体血清关节腔内注射对骨性关节炎软骨细胞凋亡率、关节腔内炎性因子浓度的影响.方法:成年雄性犬22只,行双下肢"前交叉韧带横断术"建立膝关节骨性关节炎(osteoarthritis,OA)模型后,随机分为四组:空白对照组A(左膝)vs自体血清组B(右膝)(n=11);布比卡因对照组C(左膝)vs透明质酸钠组D(右膝)(n=11),分别进行不同膝关节腔内注射.于治疗前、疗程结束后第2、4、8周进行关节软骨细胞凋亡率(TUNEL末端荧光标记法)、关节腔炎性因子IL-1、IL-6、TNF-α浓度的测定(ELISA法).结果:自体血清B组治疗后2、4、8周的软骨细胞凋亡率和术前、其他三组治疗后相比显著降低(P＜0.05).A、C、D组治疗前、后软骨细胞凋亡率差异没有显著性(P＞0.05).自体血清组B和透明质酸D组治疗后2、4、8周与治疗前及空白对照A组、布比卡因C组之间相比均可以有效抑制关节腔内IL-1、IL-6水平(P＜0.05).A组和C组间治疗前、后各时点差异无显著性(P＞0.05).TNF-α水平各组间治疗前、后没有显著差异(P＞0.05).结论:自体血清关节腔内注射可有效降低OA关节软骨细胞调亡率和关节腔内IL-1和IL-6浓度.

EFFECT OF INTRA-ARTICULAR AUTOLOGOUS SERUM INJECTION ON THE CHONDROCYTE APOPTOTIC RATE OF OSTEOARTHRITIS

Objective:To investigate the effect of intra-articular autologous serum injection on the chondrocyte apoptotic rate and inflammatory factors of OA.Methods:Twenty-two male dogs were randomly divided into four groups for intra-articular injection after they accepted anterior cruciate ligament (ACL) operation.Group A ( control group) received 0.5ml saline whereas Group B ( autologous serum group),Group C ( bupivacaine group) and Group D ( hyaluronic acid-sodium group) had 0.5 ml ( serum 0.3ml plus 0.1% bupivacaine),0.5ml (0.1% bupivacaine) and 0.5ml( hyaluronic acid-sodium 0.3ml plus 0.1% bupivacaine),respectively.All dogs in the four groups received intra-articular injection once a week for 3 weeks.The changes of apoptofic rate of chondrocyte and the concentrations of IL-1 ,IL-6 and TNF-α in articular fluid were detected before the treatment and 2,4,and 8w after the treatment.Resuits:The apoptotic rate of chondrocyte in group B after injection treatment was significantly lower than those in all groups before and the three other groups at 2,4,8w after treatment(P ＜0.05).There were no significant changes in apoptotic rate in group A,C and D before treatment and after treatment.The IL-1 and IL-6 concentrations in group B and D were lower than those in group A and C at 2,4,8w after the injection treatment (P ＜ 0.05).In group A and C,IL-1 and IL-6 concentrations had no statistic differences between before and after injection treatment ( P ＞ 0.05 ).The TNF-α levels were similar among the four groups at all time.Conclusion:Autologous serum intra-articular injection can decrease chondrocyte apoptotic rate and intra-articular IL-1 and IL-6 concentrations of OA.