膝骨关节炎滑液中可溶性晚期糖基化终末产物受体水平与其病变程度的相关性

背景：研究表明骨关节炎患者关节滑液内可溶性晚期糖基化终末产物受体水平可能与关节炎病变的严重程度存在负相关,但在中国报道较少。目的：观察膝关节骨关节炎患者关节滑液内可溶性晚期糖基化终末产物受体水平与其病变严重程度的关系。方法：共纳入46名膝关节骨关节炎患者及14名健康对照者,纳入的骨关节炎患者符合美国风湿病学会骨关节炎的临床诊断标准。采用Kellgren-Lawrence的标准对膝关节骨关节炎病变严重程度进行分级,使用人可溶性晚期糖基化终末产物受体水平酶联免疫吸附试剂盒在酶标仪下检测测关节滑液的可溶性晚期糖基化终末产物受体水平。结果与结论：膝关节骨关节炎患者关节滑液可溶性晚期糖基化终末产物受体水平较健康对照组显著降低（P〈0.01）,且与膝关节骨关节炎病变严重程度呈显著独立负相关（r=-0.587,P〈0.01）。结果表明关节滑液可溶性晚期糖基化终末产物受体水平可能与膝关节骨关节炎病变的严重性和进展程度相关。     

不同年龄段骨关节炎患者关节滑液中基质蛋白多糖的变化

目的:通过观察不同年龄段骨关节炎患者滑液中关节软骨基质蛋白多糖的变化与正常人比较,探索建立早期骨关节炎滑液中生化指标判断标准。方法:选择2002-01/2003-04上海中医药大学附属曙光医院骨科门诊治疗的膝关节骨关节炎患者60例,平均年龄47岁。无明显骨赘形成和关节间隙狭窄影像学表现,患者知情并同意。按年龄分为30～39岁组,平均年龄35.1岁;40～49岁组,平均年龄44.9岁;≥50岁组,平均年龄65.4岁。选择同期无关节疾患的正常者10例为正常对照组,参与者均知情同意,平均年龄38.7岁。收集患者和正常人的关节滑液2～5mL,应用酶联免疫吸附测定法检测滑液样本中蛋白多糖的水平。结果:纳入患者60例,正常者10人,均进入结果分析。应用酶联免疫吸附测定法检测不同年龄段骨关节炎组与正常组关节滑液中蛋白多糖含量:正常对照组滑液中蛋白多糖水平为(29.8±8.4)μg/L,30～39岁组升高[(94.9±74.2)μg/L,40～49岁达到最高[(288.7±118.6)μg/L,P<0.01],≥50岁组明显降低[(178.6±126.1)μg/L],但仍高于正常对照组和30～39岁组(P<0.01)。结论:骨关节炎患者滑液中蛋白多糖含量明显高于正常对照组,提示骨关节炎患者关节滑液中蛋白多糖含量可以作为判断早期骨关节炎的生化指标。     

不同程度膝骨关节炎患者滑液中几种细胞因子水平变化

目的探讨关节滑液中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)含量与膝骨关节炎(OA)病变程度之间的关系。方法提取31例不同程度膝骨关节炎患者(OA组),8例对照组(非OA组)的膝关节滑液,采用酶联免疫吸附法(ELISA法)测定IL-1β、IL-6;放射免疫法检测透明质酸(HA)的水平。结果膝OA组关节滑液中IL-1β、IL-6的水平显著高于对照组(P<0.01),而HA含量则显著低于对照组(P<0.01)。轻度患者滑液中IL-6及HA已分别显著增高及降低(P<0.05)。IL-1β、IL-6的水平均有随病情程度加剧而升高的趋势。相关分析的结果显示滑液中IL-1β水平与病情程度呈正相关(r=0.48,P<0.01)。结论IL-1β、IL-6在骨关节炎的发病及病情发展中起重要作用。但在体内环境下单个细胞因子不造成关节滑液中HA的减少。     

联合检测糖基化终末产物受体、糖化血红蛋白与冠状动脉钙化程度的相关性

目的：通过联合检测糖代谢异常患者糖基化终末产物受体（可溶性晚期糖基化终末产物受体sRAGE、内源性分泌型晚期糖基化终末产物受体esRAGE、裂解型晚期糖基化终末产物受体cRAGE）、糖化血红蛋白（HbA1C）,探讨其与冠状动脉钙化程度的相关性。方法选取住院患者96例,分为正常对照组（n＝30）、糖耐量异常组（n＝31）、糖尿病组（n＝35）。检测各组患者的sRAGE、esRAGE、cRAGE、HbA1C 水平,评估其与冠状动脉钙化程度的相关性。结果3组患者的 sRAGE、esRAGE、cRAGE、HbA1C水平为正常对照组＜糖耐量异常组＜糖尿病组,并具有统计学差异（P＜0．05）,且伴随着它们的升高,冠状动脉钙化积分值也逐渐升高（P＜0．05）。结论 sRAGE、esRAGE、cRAGE、HbA1C水平与冠状动脉钙化积分呈正相关的关系。联合检测糖基化终末产物受体、糖化血红蛋白可以预测糖代谢异常患者发生冠状动脉疾病的可能性,并可评估其病情严重程度及预后。     

血浆可溶性晚期糖基化终末产物受体对急性呼吸窘迫综合征的诊断价值及预后意义

目的 探讨血浆可溶性晚期糖基化终末产物受体对急性呼吸窘迫综合征诊断的价值及预后意义.方法 本研究为前瞻性病例对照研究,将201 1年2月至2012年9月东南大学附属第二医院重症监护病房（ICU）收治的43例符合2012年急性呼吸窘迫综合征柏林定义及诊断标准患者,根据急性呼吸窘迫综合征柏林定义的患者氧合状态分为轻、中、重度三组,同时收集无肺损伤的住院患者20例作为对照组,根据28 d转归将急性呼吸窘迫综合征组分为生存组和死亡组两个亚组.入院24h内测定血常规、血气分析、血生化、C反应蛋白（CRP）,记录最高体温（T）,进行急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、序贯器官衰竭估计（SOFA）评分;采用酶联免疫吸附法（ELISA）检测可溶性晚期糖基化终末产物受体水平.采用SPSS 17.0统计分析软件进行数据处理.计量资料采用方差或Mann-Whitney U检验,计数资料比较采用x2检验;绘制受试者工作特征曲线（ROC）.结果 急性呼吸窘迫综合征组患者血浆可溶性晚期糖基化终末产物受体浓度均显著高于无肺损伤组[377 （286.3 ～ 548.0）pg/ml]（P均＜0.05）,中、重度急性呼吸窘迫综合征组[分别为3188（1984～ 3042）,3273 （3170～3265） pg/ml]患者的可溶性晚期糖基化终末产物受体水平高于轻度急性呼吸窘迫综合征组[1707（1649～ 1870） pg/ml] （P ＜0.05）;死亡组可溶性晚期糖基化终末产物受体浓度[2996（2768～3319）pg/ml]明显高于生存组[2147（1965 ～ 2449） pg/ml],有统计学意义;可溶性晚期糖基化终末产物受体诊断急性呼吸窘迫综合征的ROC曲线下面积为0.912,以842 pg/ml为截断值,灵敏度为92.7％,特异度为87.8％,优于CRP.结论 血浆可溶性晚期糖基化终末产物受体水平对急性呼吸窘迫综合征诊断有一定价值,高浓度的可溶性晚期糖基化终末产物受体与急性呼吸窘迫综合征不良预后相关.     

巨噬细胞移动抑制因子与膝骨关节炎的相关性研究

目的探讨MIF在膝骨关节炎中的作用及其与IL-1β的相关性。方法研究对象包括膝骨关节炎患者45例,正常人28例,应用ELISA测定MIF和IL-1β在关节滑液中的表达程度。结果试验组与对照组的滑液中MIF及IL-1β表达水平作单因素方差分析。MIF的KOA试验组与对照组比较有统计学意义(P<0.01),KOA患者的滑液中MIF的水平显著高于对照组。IL-1β的试验组与对照组比较有统计学意义(P<0.01),KOA患者的滑液中IL-1β的水平显著高于对照组。试验组中MIF与IL-1β水平作Spearman相关分析,相关系数为r=0.945(P<0.01),两者呈正相关。结论MIF可能是KOA发病过程中促进关节滑液炎症、介导软骨退变的重要因子。     

CCL5、CCL18、CXCL13在类风湿关节炎患者血清和滑液中的表达及临床意义

目的研究趋化因子配体L5(CCL5)、趋化因子配体18(CCL18)、CXC趋化因子L13(CXCL13)在类风湿关节炎(RA)患者血清和滑液中的表达并分析其临床意义。方法选取本院2015年1月-2018年12月间收治的91例RA患者纳入RA组,另选取同期本院收治的91例骨关节炎(OA)患者纳入OA组,对比两组患者血清与患关节滑液中CCL5、CCL18、CXCL13水平,分析CCL5、CCL18、CXCL13水平与RA发生的相关性;对RA组患者分别以红细胞沉降率计算的28个关节疾病活动指数(DAS28ESR)、临床疾病活动性指数(CDAI)、简化疾病活动性指数(SDAI)评估病情活动程度,分析RA患者病情活动程度与血清、患关节滑液CCL5、CCL18、CXCL13水平的相关性。结果 RA组患者血清CCL5、CCL18、CXCL13水平高于OA组患者,差异有统计学意义(P<0.05);RA组患者患关节滑液CCL5、CCL18、CXCL13水平高于OA组患者,差异有统计学意义(P<0.05);血清、患关节滑液CCL5、CCL18、CXCL13水平与RA疾病发生均具有高度正相关性,r≥0.8,P<0.05;血清、患关节滑液CCL5、CCL18、CXCL13水平与RA病情活动程度均具有高度正相关性,r≥0.8,P<0.05。结论血清、患关节滑液CCL5、CCL18、CXCL13水平与RA的发生及RA活动度均具有明确正相关性,可为RA的临床诊断与病情活动程度评估提供重要参考。     

糖基化终末代谢产物及其受体与动脉粥样硬化的关系及抑制剂的研究进展

正随着人类社会文明的发展,随之而来的各种慢性疾病成为了困扰世界各国的公共健康问题,尤其糖尿病的患病率呈逐年增加趋势。糖尿病的各种大血管和微血管病变成为患者致残率和致死率增加的重要原因,这是因为糖尿病患者的持续高血糖状态导致晚期糖基化终末产物(advanced glycation end products,AGEs)明显增加,该产物与糖基化终末产物受体(receptor of advanced     

不同年龄段骨关节炎患者关节滑液中基质蛋白多糖的变化

目的：通过观察不同年龄段骨关节炎患者滑液中关节软骨基质蛋白多糖的变化与正常人比较，探索建立早期骨关节炎滑液中生化指标判断标准。方法：选择2002—01／2003—04上海中医药大学附属曙光医院骨科门诊治疗的膝关节骨关节炎患者60例，平均年龄47岁。无明显骨赘形成和关节间隙狭窄影像学表现，患者知情并同意。按年龄分为30-39岁组，平均年龄35．1岁；40～49岁组，平均年龄44．9岁；≥50岁组，平均年龄65．4岁。选择同期无关节疾患的正常者10例为正常对照组，参与者均知情同意，平均年龄38．7岁。收集患者和正常人的关节滑液2-5mL，应用酶联免疫吸附测定法检测滑液样本中蛋白多糖的水平。结果：纳入患者60例，正常者10人，均进入结果分析。应用酶联免疫吸附测定法检测不同年龄段骨关节炎组与正常组关节滑液中蛋白多糖含量：正常对照组滑液中蛋白多糖水平为（29．8&;#177;8．4）μg／L，30～39岁组升高[（94．9&;#177;74．2）μg／L，40～49岁达到最高[（288．7&;#177;118．6）μg／L，P〈0．01]，≥50岁组明显降低[（178．6&;#177;126．1）μg／L]，但仍高于正常对照组和30-39岁组（P〈0．01）。结论：骨关节炎患者滑液中蛋白多糖含量明显高于正常对照组，提示骨关节炎患者关节滑液中蛋白多糖含量可以作为判断早期骨关节炎的生化指标。     

透明质酸、转化生长因子β1在膝关节骨性关节炎发病中的作用探讨

目的 探讨透明质酸（HA）、转化生长因子β1（TGFβ1）在膝关节骨性关节炎（OA）发病中的作用。方法提取23例OA病变轻微患者（OA第一组），28例病变严重患者（OA第二组），6例对照者（盘状半月板组）的滑膜组织及关节液，采用免疫组织化学方法检测膝关节滑膜组织中HA、TGFβ1的阳性细胞率及通过夹心ELISA法测定膝关节滑液中HA、TGFβ1含量。结果本组57份膝关节滑膜组织及关节滑液标本中，无论是对照组还是OA组中均能测出HA、TGFβ1。OA病变轻微组膝关节滑膜组织及关节滑液标本中HA、TGFβ1含量与对照组比较无显著性差异（P〉0.05），OA病变严重组膝关节滑膜组织及关节滑液标本中HA、TGFβ1含量显著低于病变轻微组和对照组（P〈0．05）。结论HA、TGFβ1在膝关节骨性关节炎的发病中起重要作用。HA与TGFβ1减少程度与OA关节软骨损伤程度具有一定的相关性。     

Soluble receptor for advanced glycation end products (sRAGE) in plasma and synovial fluid is inversely associated with disease severity of knee osteoarthritis

Objectives:The aim of this study was to measure soluble receptor for advanced glycation end products (sRAGE) in plasma and synovial fluid of knee osteoarthritis (OA) patients and to determine the correlation between sRAGE levels and disease severity.Design and methods:Thirty-six OA patients and 15 healthy controls were enrolled in this study. OA grading was performed using the Kellgren–Lawrence classification. sRAGE levels in plasma and synovial fluid were analyzed by enzyme-linked immunosorbent assay.Results:Plasma sRAGE levels were significantly lower in OA patients than in healthy controls (P = 0.01). sRAGE levels in plasma were remarkably higher with regard to paired synovial fluid (P = 0.001). Additionally, sRAGE concentrations in plasma and synovial fluid showed significant inverse correlation with disease severity (r = ?0.65, P < 0.001 and r = ?0.55, P = 0.001, respectively). Further analysis showed that there was a strong positive correlation between plasma and synovial sRAGE concentration (r = 0.81, P < 0.001).Conclusions:sRAGE levels were significantly lower in OA patients compared with controls, and sRAGE levels in plasma and synovial fluid also decreased significantly as the disease severity increased. Accordingly, sRAGE levels could be used as a biochemical marker for assessing the severity and progression of knee OA.     

Soluble lectin-like oxidized low-density lipoprotein receptor-1 levels in synovial fluid are correlated with disease severity of knee osteoarthritis

Objectives

This study was aimed to measure soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels in serum and synovial fluid (SF) of knee osteoarthritis (OA) patients and to investigate the correlation between sLOX-1 levels and the disease severity.

Design and methods

Two hundred and sixteen OA patients and 83 healthy controls were enrolled in this study. All OA patients were scored for Kellgren–Lawrence (KL) grade (0–4). The sLOX-1 levels were measured by enzyme-linked immunosorbent assay (ELISA).

Results

In OA patients, the mean sLOX-1 levels in SF were markedly lower than those in paired serum samples (P < 0.01). The SF sLOX-1 levels increased with higher KL grade (P < 0.01) and were significantly correlated with disease severity (r = 0.324, P < 0.01). SF sLOX-1 level was the independent factor for predicting the disease severity of OA (β: 0.281, 95%CI: 0.145–0.396).

Conclusions

SF sLOX-1 levels were independently and positively associated with disease severity in knee OA.     

Plasma and synovial fluid sclerostin are inversely associated with radiographic severity of knee osteoarthritis

ObjectiveThe purpose of this study was to analyze sclerostin in plasma and synovial fluid of knee osteoarthritis (OA) patients and to investigate the association between sclerostin levels and radiographic severity.Design and methodsA total of 190 subjects (95 knee OA patients and 95 healthy controls) were recruited in the present study. Sclerostin levels in plasma and synovial fluid were assessed using an enzyme-linked immunosorbent assay. OA grading was performed using the Kellgren–Lawrence classification.ResultsPlasma sclerostin levels were significantly lower in OA patients than in healthy controls (P = 0.004). Additionally, sclerostin levels in plasma were significantly higher with respect to paired synovial fluid (P < 0.001). Moreover, sclerostin levels in plasma and synovial fluid demonstrated a significant inverse correlation with the radiographic severity of knee OA (r = − 0.464, P < 0.001 and r = − 0.592, P < 0.001, respectively). Subsequent analysis revealed that there was a positive correlation between plasma and synovial sclerostin levels (r = 0.657, P < 0.001).ConclusionsSclerostin was significantly lower in OA plasma samples when compared with healthy controls. Plasma and synovial fluid sclerostin levels were inversely associated with the radiographic severity of knee OA. Therefore, sclerostin may be utilized as a biochemical marker for reflecting disease severity in primary knee OA.     

Correlation of plasma and synovial fluid osteopontin with disease severity in knee osteoarthritis

Objectives

The purposes of this study were to examine osteopontin levels in both plasma and synovial fluid of patients with primary knee osteoarthritis (OA) and to investigate their relationship with severity of the disease.

Design and methods

Thirty-two patients aged 53-83 years with knee OA and 15 healthy controls were enrolled in this study. Anteroposterior knee radiographs were taken to determine the disease severity of the affected knee. The radiographic grading of OA in the knee was performed by using the Kellgren-Lawrence criteria. Osteopontin levels in the plasma and synovial fluid were measured using enzyme-linked immunosorbent assay.

Results

The mean plasma osteopontin concentration of the knee OA patients was significantly higher compared with that of healthy controls (168.8 ± 15.6 vs 67.2 ± 7.7 ng/mL, P < 0.0001). Osteopontin levels in synovial fluid were significantly higher with respect to paired plasma samples (272.1 ± 15.0 vs 168.8 ± 15.6 ng/mL, P < 0.001). In addition, plasma osteopontin levels showed a positive correlation with synovial fluid osteopontin levels (r = 0.373, P = 0.035). Subsequent analysis showed that plasma osteopontin levels significantly correlated with severity of disease (r = 0.592, P < 0.001). Furthermore, the synovial fluid levels of osteopontin also correlated with disease severity (r = 0.451, P = 0.01).

Conclusion

The data suggest that osteopontin in plasma and synovial fluid is related to progressive joint damage in knee OA. Osteopontin may serve as a biochemical marker for determining disease severity and could be predictive of prognosis with respect to the progression of knee OA.     

Association of MIF in serum and synovial fluid with severity of knee osteoarthritis

ObjectiveRecent evidences suggest that inflammation contributes to the development and progression of osteoarthritis (OA). This study aims to determine macrophage migration inhibitory factor (MIF) levels in serum and synovial fluid (SF) of patients with knee OA and to analyze the association of MIF levels with the radiographic severity of OA.Design and methods224 patients with knee OA and 186 healthy controls were enrolled in this study.ResultsHigher levels of serum MIF were found in knee OA patients compared with healthy controls. Knee OA patients with Kellgren and Lawrence (KL) grade 4 showed significantly elevated MIF levels in serum and SF compared with those with KL grade 2 and 3. MIF levels in serum and SF of knee OA patients were significantly related to disease severity evaluated by KL grading criteria.ConclusionMIF levels in serum and SF were closely related to the radiographic severity of OA.     

Expression of synovial fluid and articular cartilage VIP in human osteoarthritic knee: A new indicator of disease severity?

Objectives

Vasoactive intestinal peptide (VIP) is a molecule shared by the neuroendocrine immune network and is considered to be a potential candidate for treatment of inflammatory and autoimmune diseases. Although some recent studies demonstrate that VIP has a protective role in animal RA models, its variant in different disease grade of OA remains uncertain.

Design and methods

Fifty patients with primary knee OA and ten controls with severe trauma were enrolled. Synovial fluid and articular cartilage samples were collected from specimens of total knee arthroplasty (TKA) or knee above amputation. VIP levels in these samples were assessed by ELISA and immunohistochemistry. Kellgren–Lawrence criteria and Mankin score were taken to determine the disease severity.

Results

Compared to the controls, OA patients have lower VIP concentration in synovial fluid (659.70 ± 112.79, 95%CI 579.01–740.38 vs 470.83 ± 156.40, 95%CI 426.38–515.28 pg/mL, P < 0.001) and articular cartilage (0.26 ± 0.02, 95%CI 0.24–0.28 vs 0.20 ± 0.04, 95%CI 0.18–0.21, P < 0.001). Subsequent analysis show that the VIP expression in synovial fluid is markedly correlated with its OD in articular cartilage (Pearson's r = 0.580, P < 0.001). Furthermore, the synovial fluid and articular cartilage levels of VIP both demonstrated to be negatively correlated with severity of disease (Spearman's ρ = 0.838, P < 0.001; Spearman's ρ = 0.814, P < 0.001).

Conclusions

VIP in synovial fluid and articular cartilage is negatively associated with progressive joint damage in OA and is a potential indictor of disease severity.     

程序性细胞死亡因子5在活动性类风湿关节炎患者中的水平变化

目的：探究程序性细胞死亡因子5（programmed cell death factor 5,PDCD5）在类风湿关节炎（rheumatoid arthritis, RA）患者中的表达情况,并探讨PDCD5在RA发病中的可能作用。方法：采用酶联免疫吸附试验检测36例活动性RA患者和35例骨关节炎（osteoarthritis,OA）患者的血清和关节液中的PDCD5、白细胞介素6（interleukin 6,IL-6）水平,另以33名健康人的血清PDCD5水平作为对照（对照组）,比较3组间以上各指标水平的差异。同时再检测RA患者的C反应蛋白（C reaction protein, CRP）、红细胞沉降率（erythrocyte sedimentation rate, ESR）、类风湿因子（rheumatoid factor,RF）和环瓜氨酸肽（cyclic citrullinated peptide, CCP）,记录其肿胀关节数（swollen joint count,SJC）、疼痛关节数（tender joints count, TJC）,作为疾病活动指数参考指标。结果：RA组的血清PDCD5水平[（32.47±12.79） ng/mL]显著高于OA组[（12.79±9.84） ng/mL]及对照组[（18.40±18.97） ng/mL];RA组关节液中的PDCD5水平[（47.75±21.94） ng/mL]亦高于OA组[（19.33±11.25） ng/mL]。RA患者血清中的PDCD5水平与IL-6水平呈负相关（r=-0.431）,但在关节液中未观察到两者间具有相关性。Pearson分析显示,RA患者血清中的PDCD5水平与CRP、ESR、SJC、TJC呈负相关（R值分别为-0.523、-0.701、-0.845、-0.943）,但与CCP及RF水平间无统计学相关性。结论：活动性RA患者的血清及关节液中PDCD5的水平升高,而其表达失调可能与IL-6水平相关。     

Soluble P selectin in synovial fluid level is correlated with the radiographic severity of knee osteoarthritis

BackgroundRecent studies provide evidence that inflammation is a feature of the disease process in Osteoarthritis (OA). The clinical significance of P selectin (Ps) in OA has not been adequately studied and the association between Ps level and OA severity remains unknown.MethodsWe enrolled 120 knee OA subjects and 45 controls. All patients were scored for Kellgren–Lawrence grade (0–4). The Ps in serum and synovial fluid (SF) as well as serum C-reactive protein (CRP) levels were detected.ResultsThe mean Ps level in OA subjects was markedly increased than that in controls. In OA patients, the SF Ps levels increased with the severity of KL scores and significantly correlated with severity of disease (r = 0.546, P < 0.001) and serum CRP level (r = 0.488, P < 0.001). However, the serum Ps level did not show a significant correlation with the severity of OA.ConclusionThe Ps levels in SF were significantly correlated with the severity of OA, suggesting that it may be used as a biomarker to evaluate the progression of OA.     

Interleukin-6 and interleukin-8 levels in serum and synovial fluid of patients with osteoarthritis

Concentrations of interleukin (IL)-6 and IL-8 in serum and synovial fluid obtained from patients with osteoarthritis (OA) of the knee were determined by the chemiluminescence-ELISA (CL-ELISA) method, the sensitivity of which is 100-1,000 times greater than that of the conventional ELISA method. The results were compared with those obtained from patients with rheumatoid arthritis (RA) and from healthy subjects. The mean IL-6 and IL-8 levels in synovial fluid indicated higher concentrations in RA than in OA. The IL-6 and IL-8 levels in serum were significantly higher in RA and OA relative to controls. Among OA patients in whom remarkable improvement was noted in hydrarthrosis, the synovial fluid IL-6 and IL-8 levels at the initial examination were relatively higher, and were markedly decreased after treatment with sodium hyaluronate (NaHA). Among those in whom no improvement was noted in hydrarthrosis, the synovial fluid IL-6 and IL-8 levels at the time of initial examination were relatively lower, and hydrarthrosis was not significantly improved even after treatment with NaHA. In addition, there was a tendency for the synovial fluid IL-6 and IL-8 levels to decrease as HA levels increased. Evaluation of X-ray findings revealed that the IL-6 levels in synovial fluid at the initial examination in low-grade cases tended to be significantly higher than in high-grade cases. In low-grade cases, as determined by X-ray findings, there was a significant decrease in IL-6 levels in synovial fluid after treatment with NaHA.