维药买朱尼对骨关节炎大鼠模型关节软骨中基质金属蛋白酶1和基质金属蛋白酶抑制剂1的影响

背景:骨关节炎患者关节软骨的损害与基质金属蛋白酶1和基质金属蛋白酶抑制剂失平衡有关.目的:观察基质金属蛋白酶1、基质金属蛋白酶抑制剂1在关节软骨中的表达及维药买朱尼对其影响.方法:将20只SD大鼠采用改良Hulth造模法建立大鼠膝骨关节炎模型,按随机数字表法随机等分为买朱尼组和模型组,建模第2周开始分别灌胃维药买朱尼和生理盐水,连续4周.结果与结论:相比于模型组,买朱尼组大鼠膝关节软骨退变程度减轻,软骨大体评分及Mankin评分降低(P < 0.05),且膝关节软骨细胞中基质金属蛋白酶1的表达降低,基质金属蛋白酶抑制剂1的表达增加(P < 0.05).说明维药买朱尼可以通过下调基质金属蛋白酶1的表达水平、上调抑制剂的表达水平,对软骨产生保护作用.     

骨关节炎时内源性细胞因子及基质金属蛋白酶抑制因子1对关节软骨的影响

背景:研究发现,细胞因子通过影响关节软骨基质的分解代谢和合成代谢的平衡来参与骨关节炎的形成,其中白细胞介素1β、基质金属蛋白酶抑制因子1在其中起重要作用。目的:观察内源性细胞因子白细胞介素1β及基质金属蛋白酶抑制因子1与骨关节炎关节软骨退变的关系。方法:纳入2006-06/2009-09于哈尔滨医科大学附属第五医院就诊的原发性骨关节炎患者37例,在患者行关节镜检时抽取关节液及分离平滑光亮的滑膜组织。另取10例正常关节液标本及平滑光亮的滑膜组织标本作为对照。结果与结论:ELISA法检测结果显示骨关节炎患者关节液和滑膜组织中白细胞介素1β、基质金属蛋白酶抑制因子1水平均显著高于正常水平,且患者骨关节炎越严重,关节液和滑膜组织中白细胞介素1β、基质金属蛋白酶抑制因子1的水平越高。说明关节液中白细胞介素1β、基质金属蛋白酶抑制因子1水平与骨关节炎、关节软骨退变有关。     

体外冲击波治疗兔膝骨关节炎：白细胞介素1β及基质金属蛋白酶13的表达

背景：白细胞介素1β和基质金属蛋白13能促进软骨细胞的分解代谢,抑制软骨细胞的合成修复能力,引起细胞外基质的降解,在骨关节炎的发生中有十分重要的作用。 目的：观察体外冲击波对兔膝骨关节炎软骨细胞中白细胞介素1β和基质金属蛋白酶13表达的影响。 方法：将30只新西兰兔随机分为治疗组、模型组、对照组,每组10只。治疗组和模型组均采用改良伸直位固定6周,制备兔膝骨关节炎模型。治疗组造模后给予体外冲击波治疗1次,能流密度0.1 mJ/mm2,冲击次数1000次。对照组不作任何处理。各组兔于治疗后4周处死,取膝关节液和关节软骨。苏木精-伊红染色和甲苯胺蓝染色法检测各组膝关节病理学形态改变,采用酶联免疫吸附法测定关节液白细胞介素1β水平,免疫组化法检测白细胞介素1β和基质金属蛋白酶13的表达。 结果与结论：治疗组和模型组关节液白细胞介素1β水平较对照组明显增高（P 〈0.01）,治疗结束后治疗组关节液白细胞介素1β水平较模型组下降（P 〈0.05）。治疗组和模型组软骨组织Mankin评分较对照组明显增高（P〈0.01）,治疗结束后治疗组软骨组织Mankin评分较模型组下降（P〈0.05）。治疗组和模型组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较对照组明显增高（P〈0.01）,治疗结束后治疗组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较模型组下降（P〈0.05）。结果可见体外冲击波能下调膝骨关节炎软骨细胞白细胞介素1β和基质金属蛋白酶13的表达,促进Ⅱ型胶原和蛋白聚糖的合成,从而对膝骨关节炎起防治作用。     

抗骨增生胶囊含药血清对软骨细胞增殖凋亡及基质金属蛋白酶分泌的影响

背景:抗骨增生胶囊在治疗骨关节疾病方面有很好的疗效,基础研究多集中于颈椎病等骨关节疾病上.目的:拟观察抗骨增牛胶囊含药血清对白细胞介索1β引起的软骨细胞增殖凋亡及基质金属蛋白酶分泌的影响.设计、时间及地点:分组对照体外细胞学实验,于2007-03/09在河北医科大学解剖教研室细胞培养中心完成.材料:新生1周sD大鼠,用于培养软骨细胞;体质量200 g左右SD大鼠10只,以中药水溶液灌胃后定时取血制备含药血清.方法:采用胶原酶NB4消化法从大鼠关节软骨中分离出软骨细胞并进行原代和传代培养,实验分为3组:空白血清组:90%L-DMEM 10%空白血清,每口给予同等量的生理盐水;白细胞介索1β组(90%DMEM 10%空白血清 自细胞介素1β);中药血清 白细胞介素1β组(90%DMEM 10%中约血清 白细胞介素1β).白细胞介素1β加入量为5μg/L,培养72 h.将实验用细胞消化传代后制成单细胞悬液,以1×108L-1的密度接种于96孔培养板,100μL/孔,每组6孔.主要观察指标:倒置显微镜下观察中药含药血清对软骨细胞增殖的影响:四甲基偶氮唑盐比色法检测其各孔吸光度变化;流式细胞仪分析凋亡细胞百分率;基质金属蛋白酶13 Elisa试剂盒检测不同组基质金属蛋白酶13分泌情况.结果:在正常培养基条件下,细胞形态均匀,死亡脱落细胞较少.空白血清组软骨细胞的增殖速度缓慢,细胞较稀疏.白细胞介索1β组细胞明显稀疏,部分细胞胞浆中窄泡增多,细胞核形态不规则.在中药血清培养基作用下,软骨细胞增殖的速度较白细胞介素1 B组快,胞体显著增大,细胞核形态规则.白细胞介素1β组细胞增殖数量减少,凋亡细胞百分率增加,其培养的细胞上清液中基质金属蛋白酶13含量升高,抗骨增生胶囊含药血清可对抗白细胞介素1β对软骨细胞的影响.结论:体外条件下,抗骨增生胶囊含药血清能够抑制白细胞介素1β诱导的软骨细胞凋亡:降低基质金属蛋白酶13水平.     

关节软骨损伤后体外培养软骨细胞的功能变化

背景:关节软骨损伤可以影响软骨细胞功能,诱发创伤性骨关节炎.目的:观察关节软骨损伤后体外培养的软骨细胞功能的变化.方法:通过酶消化法分离培养高能量、低能量撞击后和正常兔膝关节透明软骨细胞,观察创伤能量对软骨细胞生存能力的影响;检测软骨细胞合成蛋白多糖和Ⅱ型胶原能力,检测细胞中白细胞介素1β和核转录因子κB mRNA表达水平,检测细胞合成白细胞介素1β和基质金属蛋白酶1的表达.结果与结论:高能量和低能量关节软骨损伤后,软骨细胞的存活率下降,原代细胞的贴壁细胞数量减少,贴壁时间延长,生长曲线下移,细胞甲苯胺蓝染色异染反应减弱,Ⅱ型胶原免疫组化染色强度减弱,软骨细胞中白细胞介素1β和核转录因子κB mRNA表达水平上升,细胞培养液中白细胞介素1β和基质金属蛋白酶1的质量浓度升高,其中高能量组效果更为显著(P < 0.05).说明关节软骨损伤后软骨细胞的功能受到影响,受损程度与创伤强度及炎性细胞因子的表达相关.     

维药买朱尼对关节软骨前炎性因子的影响

背景：骨关节炎病理过程中,白细胞介素1β被认为是促进软骨基质降解和关节软骨破坏的最重要的细胞因之一。目的：观察白细胞介素113在关节软骨中的表达,并观察维药买朱尼对其的影响。方法：将40只SD大鼠随机数字表法随机等分为模型对照组、维药买朱尼组、假手术组、正常对照组。模型对照组和维药买朱尼组采用改良Hulth造模法建立大鼠膝骨关节炎模型,假手术组仅显露膝关节,不切断韧带,不切除内侧半月板。维药买朱尼组建模第2周开始灌胃维药买朱尼10．31mg／（kg·d）,模型组及假手术组大鼠均灌服等量生理盐水,连续4周。结果与结论：模型组软骨退变程度明显重于维药买朱尼组,模型组软骨大体评分及Mankin评分均明显高于维药买朱尼组（P〈0．05）,模型组软骨细胞白细胞介素1β的表达强度亦明显高于维药买朱尼组（P〈0．05）。与正常对照组比较,假手术组软骨大体评分、Mankin评分及软骨细胞白细胞介素1β差异无显著性意义（P〉0．05）。结果说明,维药买朱尼可以抑制关节软骨前炎性因子白细胞介素1β的表达。     

关节软骨损伤后体外培养软骨细胞的功能变化

背景：关节软骨损伤可以影响软骨细胞功能,诱发创伤性骨关节炎。目的：观察关节软骨损伤后体外培养的软骨细胞功能的变化。方法：通过酶消化法分离培养高能量、低能量撞击后和正常兔膝关节透明软骨细胞,观察创伤能量对软骨细胞生存能力的影响;检测软骨细胞合成蛋白多糖和Ⅱ型胶原能力,检测细胞中白细胞介素1β和核转录因子κB mRNA表达水平,检测细胞合成白细胞介素1β和基质金属蛋白酶1的表达。结果与结论：高能量和低能量关节软骨损伤后,软骨细胞的存活率下降,原代细胞的贴壁细胞数量减少,贴壁时间延长,生长曲线下移,细胞甲苯胺蓝染色异染反应减弱,Ⅱ型胶原免疫组化染色强度减弱,软骨细胞中白细胞介素1β和核转录因子κB mRNA表达水平上升,细胞培养液中白细胞介素1β和基质金属蛋白酶1的质量浓度升高,其中高能量组效果更为显著（P〈0.05）。说明关节软骨损伤后软骨细胞的功能受到影响,受损程度与创伤强度及炎性细胞因子的表达相关。     

周期性张应力与软骨细胞基质金属蛋白酶的表达

背景：课题组前期研究证实,在关节软骨缺损及骨性关节炎的动物模型中,软骨细胞可过度表达基质金属蛋白酶,各种异常刺激均可能打破基质金属蛋白酶与金属蛋白酶组织抑制因子间平衡,从而导致关节软骨细胞外基质退变,软骨细胞功能下降和失调。目的：观察兔关节软骨缺损修复过程中周期性张应力对软骨细胞基质金属蛋白酶表达的影响。方法：建立兔单侧膝关节软骨缺损模型,术后10周分离软骨细胞体外培养,非手术侧软骨细胞为正常组,术侧软骨细胞随机分为高应力组、低应力组及对照组,加载幅度为sin00％,0．1,1．0,OHz的周期性张应力,于24h、48h、1周、2周和4周后RT-PCR测定各组基质金属蛋白酶2,3,9,13的表达。结果与结论：加载周期性张应力24h后,正常组及对照组间的基质金属蛋白酶2,3,9,13的表达差异有显著性意义（P《O．05）;加载周期性张应力1周、2周及4周后高应力组和低压力组间差异有显著性意义（P〈0．05）;同时发现,低应力组中基质金属蛋白酶2,3,9,13的表达持续下降,加载周期性张应力24h与4周之间的差异有显著性意义（P〈0．05）。可见力学载荷可影响兔关节软骨缺损修复过程中基质金属蛋白酶的表达,在细胞分子水平上,关节软骨缺损病理的发生发展与应力相互影响。     

周期性张应力与软骨细胞基质金属蛋白酶的表达**☆

背景：课题组前期研究证实,在关节软骨缺损及骨性关节炎的动物模型中,软骨细胞可过度表达基质金属蛋白酶,各种异常刺激均可能打破基质金属蛋白酶与金属蛋白酶组织抑制因子间平衡,从而导致关节软骨细胞外基质退变,软骨细胞功能下降和失调。目的：观察兔关节软骨缺损修复过程中周期性张应力对软骨细胞基质金属蛋白酶表达的影响。方法：建立兔单侧膝关节软骨缺损模型,术后10周分离软骨细胞体外培养,非手术侧软骨细胞为正常组,术侧软骨细胞随机分为高应力组、低应力组及对照组,加载幅度为 sin10%,0.1,1.0,0 Hz 的周期性张应力,于24 h、48 h、1周、2周和4周后 RT-PCR 测定各组基质金属蛋白酶2,3,9,13的表达。结果与结论：加载周期性张应力24 h 后,正常组及对照组间的基质金属蛋白酶2,3,9,13的表达差异有显著性意义(P <0.05);加载周期性张应力1周、2周及4周后高应力组和低压力组间差异有显著性意义(P <0.05);同时发现,低应力组中基质金属蛋白酶2,3,9,13的表达持续下降,加载周期性张应力24 h 与4周之间的差异有显著性意义(P <0.05)。可见力学载荷可影响兔关节软骨缺损修复过程中基质金属蛋白酶的表达,在细胞分子水平上,关节软骨缺损病理的发生发展与应力相互影响。     

一氧化氮合酶抑制剂对白细胞介素1β诱导软骨细胞增殖和基质金属蛋白酶表达的影响

目的:研究表明,白细胞介素1β对鼠肾细胞、心肌细胞和神经上皮细胞发挥抗增殖作用,但其是否可抑制人的软骨细胞增殖?这种抗增殖作用是否可被一氧化氮合酶抑制剂抑制尚不清楚.实验拟验证一氧化氮合酶抑制剂对人骨关节炎软骨细胞增殖及基质金属蛋白酶的影响.方法:选择2006-05/12在南方医科大学附属南方医院脊梓骨病科住院的膝骨关节炎患者8例.所有患者均符合1986年美国风湿病学会关于骨关节炎的临床诊断标准或临床及放射学诊断标准,排除其他疾病(创伤性、风湿性及感染性)所导致的骨关节炎.所有患者均在术前告知,并签有试验知情同意书.分离培养关节软骨细胞,将不同浓度(0,1,10,100 μg/L,其中0 μg/L作为对照)白细胞介素1β作用于骨关节炎软骨细胞24,48,72 h,一氧化氮合酶抑制剂氨基胍作为干扰因素,与白细胞介素1β共同作用72 h,收集细胞上清液,一氧化氮的表达量通过一氧化氮试剂盒检测,并作为检测一氧化氮合酶抑制剂活性的手段;四甲基偶氮唑盐法检测软骨细胞的增殖;xMAP技术检测软骨细胞基质金属蛋白酶1,基质金属蛋白酶3和基质金属蛋白酶9的表达.结果:①不同时间点1,10,100 μg/L白细胞介素1β组作用后的吸光度值与对照组相比,差异显著(JP＜0.05,P＜0.01);相同浓度白细胞介素1β在24,72h的吸光度值相比较,差异显著(P＜0.01).②白细胞介素1β和氨基胍(100 μmol/L)共同作用软骨细胞72 h后,各浓度组吸光度与白细胞介素1β组相比,差异显著(P＜0.01).③白细胞介素1β可促进软骨细胞一氧化氮的表达,并呈剂量依赖关系.④白细胞介素1β促进基质金属蛋白酶1和基质金属蛋白酶3的表达,与对照组相比,差异有显著性意义(P＜0.01),而软骨细胞基质金属蛋白酶9的表达在本实验中没有检测到.结论:白细胞介素1β可抑制软骨细胞增殖,诱导基质金属蛋白酶表达,这些影响可被氨基胍抑制,白细胞介素1β和氨基胍对软骨细胞的影响可能是通过一氧化氮途径发挥作用.     

Imbalance between tissue inhibitor of metalloproteinase 1 and matrix metalloproteinase 9 after cardiopulmonary resuscitation

Aims

This study aimed to determine whether (a) there was an imbalance between matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) after cardiopulmonary resuscitation (CPR) in a canine model of prolonged ventricular fibrillation (VF); (b) with the duration of VF, the degree of the imbalance would be greater; and (c) there was a relationship between the level of MMP-9 or TIMP-1 and the cardiac function.

Methods and Results

Ventricular fibrillation was electrically induced in 24 dogs. The animals were randomly divided into 3 groups (sham control, n = 8; 8-minute VF, n = 8; 12-minute VF, n = 8). Echocardiographic measurement and hemodynamic variables were recorded before VF and after return of spontaneous circulation. Tissue inhibitor of metalloproteinase 1 (TIMP-1) and MMP-9 were analyzed by Western blot and immunohistochemistry. Compared with sham controls, dogs under VF and CPR showed significantly decreased level of TIMP-1 (P < .001), and with the duration of VF, the level of TIMP-1 declined (P < .01). The level of MMP-9 did not achieve statistical significance in the 3 groups (P > .05); however, they were higher in VF and longer duration VF groups. The ratios of TIMP-1/MMP-9 were lower in VF groups (P < .05). There was a negative correlation between TIMP-1 and left atrium dimension and left ventricular diastolic dimensions (r = −0.83 and r = −0.96, respectively; P < .01) and a positive correlation between TIMP-1 and left ventricular ejection fraction (r = 0.85; P < .01).

Conclusions

There was an imbalance between TIMP-1 and MMP-9 after CPR. It may partly contribute to the postresuscitation cardiac dysfunction.     

创伤性关节炎软骨中基质金属蛋白酶13及组织特异性抑制剂1的表达

背景：关节软骨损伤后继发性退变机制仍不十分清楚。近年研究发现关节软骨细胞外基质合成与降解失衡是造成软骨变性的重要原因之一,其中基质金属蛋白酶可能起决定性的作用。目的：观察基质金属蛋白酶13及其组织特异性抑制剂1在创伤性关节炎中的表达及与软骨退变的关系。方法：将新西兰兔分别用骨水泥制作的模具从1.33kg,46cm高度和0.43kg,20cm高度进行自由落体撞击制备轻型和重型撞击创伤性关节炎兔模型。结果与结论：苏木精-伊红染色和免疫组织化学染色结果显示,基质金属蛋白酶13和组织特异性抑制剂1在两组均增高（P〈0.05）。组织特异性抑制剂1在重型撞击创伤性关节炎模型兔软骨组织中的分泌明显高于轻型撞击组（P〈0.05）。说明关节软骨在创伤后,基质金属蛋白酶13及组织特异性抑制剂1表达上调,共同作用促进了关节软骨退变,其中组织特异性抑制剂1的过量表达可能是造成关节软骨进一步损害的原因之一。     

创伤性关节炎软骨中基质金属蛋白酶13及组织特异性抑制剂1的表达

背景:关节软骨损伤后继发性退变机制仍不十分清楚。近年研究发现关节软骨细胞外基质合成与降解失衡是造成软骨变性的重要原因之一,其中基质金属蛋白酶可能起决定性的作用。目的:观察基质金属蛋白酶13及其组织特异性抑制剂1在创伤性关节炎中的表达及与软骨退变的关系。方法:将新西兰兔分别用骨水泥制作的模具从1.33kg,46cm高度和0.43kg,20cm高度进行自由落体撞击制备轻型和重型撞击创伤性关节炎兔模型。结果与结论:苏木精-伊红染色和免疫组织化学染色结果显示,基质金属蛋白酶13和组织特异性抑制剂1在两组均增高(P<0.05)。组织特异性抑制剂1在重型撞击创伤性关节炎模型兔软骨组织中的分泌明显高于轻型撞击组(P<0.05)。说明关节软骨在创伤后,基质金属蛋白酶13及组织特异性抑制剂1表达上调,共同作用促进了关节软骨退变,其中组织特异性抑制剂1的过量表达可能是造成关节软骨进一步损害的原因之一。     

The analysis of amount of matrix metalloproteinase 1 precursor, metalloproteinase 1 tissue inhibitor and cystatin C in the bronchoalveolar secretion of patients with nonspecific lung diseases

The proteinases and their inhibitors participate in the inflammatory process. The damage of lung tissue can be a result of proteinase activity. This activity is regulated by such inhibitors as metalloprvteinase 1 tissue inhibitor and cystatin C. The comparative analysis was applied concerning matrix metalloproteinase 1 precursor; metalloproteinase I tissue inhibitor and cystatin C--indicators of conditions of the "proteolysis-antiproteolysis" system in the bronchoalveolar secretion of patients with chronic obstructive lung disease, bronchial asthma and pneumonia. In the group of patients with chronic obstructive lung disease, in contrast with other groups, the significant increase of proteinase inhibitors was not detected on the tenth day of treatment after exacerbation of disease. This fact testifies the ongoing proteolytic activity and chronic inflammation under chronic obstructive lung disease.     

Thrombin suppresses matrix metalloproteinase 2 activity and increases tissue inhibitor of metalloproteinase 1 synthesis in cultured human peritoneal mesothelial cells.

OBJECTIVE: Recently, high levels of intraperitoneally generated thrombin were found in the effluent of patients treated with continuous ambulatory peritoneal dialysis (CAPD). The aim of the present study was to investigate in human peritoneal mesothelial cells (HMCs) the effect of thrombin on the activity and synthesis of matrix metalloproteinases (MMPs), which regulate the degradation of basement membrane collagen. METHODS: Cultured HMCs were isolated from omental tissue and used at confluence for the experiments. Conditioned media were obtained by incubating cells with serum-free M199 containing the relevant doses of thrombin. Activity of MMP-2 and MMP-9 were determined by an activity assay system. The antigen levels of MMPs and of the specific tissue inhibitor of metalloproteinases 1 (TIMP-1) were measured by ELISA. Northern blot analysis was applied to analyze mRNA expression of MMP-2 and TIMP-1. RESULTS: Incubation of HMCs with increasing doses of thrombin resulted in a concentration- and time-dependent suppression of MMP-2 activity. No changes in MMP-9 activity were seen. After a 48-hour stimulation period with thrombin (5 U/mL), MMP-2 activity decreased to 53% of that seen in control conditions. Antigen measurements revealed that this decrease was paralleled by a slight reduction in MMP-2 levels, which became significant at a thrombin dose of 5 U/mL [50.65 +/- 7.5 ng/10(5) cells (48 hours, 5 U/mL) vs 64.6 +/- 10.1 ng/10(5) cells (control)]. Under the same conditions, TIMP-1 levels were considerably increased [3.9 +/- 0.46 microg/10(5) cells (48 hours, 5 U/mL) vs 1.2 +/- 0.14 microg/10(5) cells (control)]. Hirudin (10 U/mL) completely inhibited the thrombin-induced effects on MMP-2 and TIMP-1 synthesis. These results were also reflected by Northern blot hybridization, where a slight decrease in MMP-2 and an increase in TIMP-1 mRNA expression were observed in response to thrombin. CONCLUSIONS: Our results suggest that high thrombin levels suppress MMP-2 activity through decreased MMP-2 and increased TIMP-1 synthesis. Thus, thrombin may promote the accumulation of basement membrane collagen. In addition to fibrin formation, this mechanism may represent a further contribution by thrombin to peritoneal thickening during CAPD.     

Proteolytic inactivation of alpha-1-proteinase inhibitor by a neutrophil metalloproteinase.

Human neutrophils triggered with phorbol myristate acetate or opsonized zymosan particles released a metalloproteinase (MP) capable of cleaving and inactivating alpha-1-proteinase inhibitor (alpha-1-PI). Sequence analysis of the amino acids in proteolyzed, native alpha-1-PI revealed a unique single cleavage site between Phe-352 and Leu-353. An analysis of the process regulating the enzyme's activity revealed that the neutrophil MP was released from cells in a latent form whose activation was tightly linked to the generation of hypochlorous acid. These results indicate that human neutrophils use chlorinated oxidants to activate a latent MP that is capable of proteolytically inactivating alpha-1-PI by cleaving the antiproteinase at a unique point in its inhibitory site region.     

基质金属蛋白酶及其抑制剂与肿瘤关系的研究进展

基质金属蛋白酶是一组蛋白水解酶，能降解细胞外基质，金属蛋白酶组织抑制剂则能抑制其水解活性，这两组酶在很多肿瘤组织中表达增高。综述了金属蛋白酶及其抑制剂表达的失衡与肿瘤侵袭及转移的关系。     

痹肿消汤对活动期类风湿关节炎患者血清基质金属蛋白酶3及其组织抑制剂1的影响

目的:观察从分子生物学水平痹肿消汤对活动期类风湿性关节炎患者血清基质金属蛋白酶3及其组织抑制剂1的影响及其治疗作用。方法:52例活动期类风湿性关节炎患者均来自2003-06/2004-06中南大学湘雅医院。随机分为痹肿消汤治疗组(简称中药组,n=27),用痹肿消汤治疗,1剂/d,水煎服2次。甲氨喋呤+柳氮磺嘧啶治疗组(简称对照组,n=25),甲氨喋呤起始量7.5mg口服,1次/周,逐渐加量至15mg,1次/周;同时配以等量叶酸口服。柳氮磺嘧啶起始量0.25g口服,3次/d,逐渐加量至0.5g,3次/d。上述两组均治疗3个月为1个疗程,于治疗前和治疗3个月后分别检测血清基质金属蛋白酶3,金属蛋白酶组织抑制剂1水平,计算两者比值。结果:按实际处理分析,中药组有2例失访,3例未能坚持完疗程而脱落,对照组有3例失访,3例出现副反应而脱落。①治疗3个月后,中药组患者(n=22)血清基质金属蛋白酶3、金属蛋白酶组织抑制剂1及两者的比值较治疗前明显降低(52.17±23.19)μg/L,(320.48±101.16)μg/L,0.190±0.118;(93.01±41.42)μg/L,(461.80±132.27)μg/L,0.227±0.132,t=6.166,8.369,2.589,P<0.01或P<0.05。②与对照组(n=19)治疗后比较基本相似(49.91±22.34)μg/L,(317.21±93.87)μg/L,0.184±0.118,P>0.05。结论:痹肿消汤可能通过调节血清基质金属     

Evidence for metalloproteinase and metalloproteinase inhibitor imbalance in human osteoarthritic cartilage.

Cartilage specimens from tibial plateaus, obtained from 13 osteoarthritic (OA) patients and seven controls, were selected from three regions: zone A, center of fibrillated area; zone B, area adjacent to fibrillation, and zone C, remote region of plateau. Acid and neutral metalloproteinases and tissue inhibitor of metalloproteinase (TIMP) were extracted with 2 M guanidine. Methods were developed to selectively destroy either proteinases or TIMP to prevent cross-reaction during assay. Acid and neutral proteinases were elevated approximately 150% in OA; TIMP was elevated approximately 50%. A positive correlation (r = 0.50) was found between acid and neutral proteinase activities in OA, but not in controls. Both proteinases were elevated two-to threefold in zones A, B, and C. However, the self-active form of the acid metalloproteinase was elevated only in zones A and B (200%); it correlated well with the Mankin scores, whereas the total activities did not. TIMP was elevated (50%) only in zones A and B. Both the proteinase levels and the Mankin score were elevated to a greater extent in the medial, than in the lateral, compartment. Titration of TIMP against the two metalloproteinases indicates that there is a small excess of inhibitor over enzymes in normal cartilage. In OA, TIMP does not increase to the same extent as the proteinases; the resultant excess of proteinases over TIMP may contribute to cartilage breakdown.