Inorganic pyrophosphate pool size and turnover rate in arthritic joints.

Recent studies have shown elevated inorganic pyrophosphate (PPi) levels in most knee joint fluid supernates from patients with pseudogout (PG) or osteoarthritis (OA) and more modestly elevated levels in some supernates from patients with gout or rheumatoid arthritis (RA) relative to PPi levels found in the venous blood plasma of normal or arthritic subjects. We measured the intraarticular PPi pool and its rate of turnover to better understand the significance of the joint fluid-plasma PPi gradient. Preliminary studies in rabbits showed that (32-P)PPi passed from joint space to blood and vice versa without detectable hydrolysis. Incubation of natural or synthetic calcium pyrophosphate dihydrate (CPPD) microcrystals with synovial fluid in vitro in the presence of (32P)PPi tracer showed no change in PPi specific activity in the supernate over a 19-h period so that exchange of PPi in solution with that in CPPD microcrystals could be ignored. Clearance rates of (32P)PPi and of (33P)Pi, as determined by serially sampling the catheterized knee joints of volunteers with various types of arthritis over a 3-h period, were nearly identical. The (32P)PPi/(32P)Pi was determined in each sample. A mixture of a large excess of cold PPi did not influence the clearance rate of either nuclide. The quantity of PPi turned over per hous was calculated from the pool size as determined by isotope dilution and the turnover rate. The residual joint fluid nuclide was shown to be (32P)PPi. The PPi pool was generally smaller and the rate of turnover was greater in clinically inflamed joints. The mean plus or minus SEM pool size (mu-moles) and turnover rate (percent/hour) in PG knees was 0.23 plus or minus 0.07 and 117 plus or minus 11.9, hydrolysis rate (%/h) to Pi was 27.7 plus or minus 13.2; in OA knees: 0.45 plus or minus 0.26 and 72 plus or minus 9.2, hydrolysis 6.9 plus or minus 0.9; in gouty knees: 0.8 plus or minus 0.41 and 50 plus or minus 11.6, hydrolysis 9.8 plus or minus 2.8; and in RA knees: 0.14 plus or minus 0.14 and 114 plus or minus 35.8, hydrolysis 236 plus or minus 116. PPi turnover (mumoles/hour) correlated with the degree of OA change present in the joint as graded by radiologic criteria irrespective of the clinical diagnosis. Mean PPi turnover in joints with advanced OA was greater than in those with mild or moderate changes (P smaller than 0.001), but the mild and moderate groups showed no significant difference. We conclude that synovial PPi turnover and elevated PPi fluid concentrations are not specific for PG patients, and that these factors alone cannot be the only determinants of CPPD crystal deposition.     

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。     

低频脉冲超声干预膝骨关节炎模型兔关节软骨及滑膜水通道蛋白3的表达

背景:研究表明,低频脉冲超声能促进全层关节软骨缺损修复,延缓实验性早期骨关节炎的病变进展。水通道蛋白3存在于关节软骨及滑膜上,并在骨关节炎的发病机制中发挥重要作用。目的:探讨低频脉冲超声对实验性膝骨关节炎兔关节软骨及滑膜水通道蛋白3表达的影响。方法:成年新西兰兔左后膝关节用管型石膏固定于伸直位制动6周制备实验性兔膝关节骨关节炎模型,造模成功后随机分为两组:实验组予以低频脉冲超声治疗(频率为1MHz,功率为2.0W),1次/d,15min/次;对照组不接受超声治疗。分别于治疗后2,4,8周,采用免疫组织化学方法观察兔关节软骨及滑膜水通道蛋白3的表达。结果与结论:随着造模后时间的延长,各组兔关节软骨及滑膜水通道蛋白3的表达均有所增加;与对照组比较,实验组兔关节软骨及滑膜水通道蛋白3表达明显降低(P<0.01)。说明低频脉冲超声能降低实验性兔膝骨关节炎关节软骨及滑膜水通道蛋白3的表达,从而缓解关节肿胀,延缓软骨及滑膜的退变,具有软骨及滑膜保护作用。     

低频脉冲超声干预膝骨关节炎模型免关节软骨及滑膜水通道蛋白3的表达

背景：研究表明,低频脉冲超声能促进全层关节软骨缺损修复,延缓实验性早期骨关节炎的病变进展。水通道蛋白3存在于关节软骨及滑膜上．并在骨天节炎的发病机制中发挥重要作用。目的：探讨低频脉冲超声对实验性膝骨关节炎兔关节软骨及滑膜水通道蛋白3表达的影响。方法：成年新西兰兔左后膝关节用管型石膏固定于伸直位制动6周制备实验性兔膝关节骨关节炎模型,造模成功后随机分为两组：实验组予以低频脉冲超声治疗（频率为1MHz,功率为2.0w）,1次/d．15min/次：对照组不接受超声治疗。分别于治疗后2,4,8周,采用免疫组纵化学方法观察兔关节软骨及滑膜水通道蛋白3的表达。结果与结论：随着造模后时间的延长,各组兔芙节软骨及滑膜水通道蛋白3的表达均有所增加;与对照组比较,实验组兔哭节软骨及滑膜水通道蛋白3表达明显降低（P〈0.01）。说明低频脉冲超声能降低实验性兔膝骨关节炎关节软骨及滑膜水通道蛋白3的表达,从而缓解关节肿胀,延缓软骨及滑膜的退变,具有软骨及滑膜保护作用。     

Persistence of fluorescent nanoparticle‐labelled bone marrow mesenchymal stem cells in vitro and after intra‐articular injection

Mesenchymal stem cells (MSCs) improve the osteoarthritis condition, but the fate of MSCs after intra‐articular injection is unclear. We used fluorescent nanoparticles (quantum dots [QDs]) to track equine MSCs (QD‐labelled MSCs [QD‐MSCs]) in vivo after intra‐articular injection into normal and osteoarthritic joints. One week after injection of QD‐MSCs, unlabelled MSCs, or vehicle, we determined the presence of QD‐MSCs in synovium and articular cartilage histologically. In vitro, we evaluated the persistence of QDs in MSCs and whether QDs affected proliferation, immunophenotype, or differentiation. In joints injected with QD‐MSCs, labelled cells were identified on the synovial membrane and significantly less often on articular cartilage, without differences between normal and osteoarthritic joints. Joints injected with QD‐MSCs and MSCs had increased synovial total nucleated cell count and protein compared with vehicle‐injected joints. In vitro, QDs persisted in nonproliferating cells for up to 8 weeks (length of the study), but QD fluorescence was essentially absent from proliferating cells within two passages (approximately 3 to 5 days). QD labelling did not affect MSC differentiation into chondrocytes, adipocytes, and osteocytes. QD‐MSCs had slightly different immunophenotype from control cells, but whether this was due to an effect of the QDs or to drift during culture is unknown. QD‐MSCs can be visualized in histological sections 1 week after intra‐articular injection and are more frequently found in the synovial membrane versus cartilage in both normal and osteoarthritic joints. QDs do not alter MSC viability and differentiation potential in vitro. However, QDs are not optimal markers for long‐term tracking of MSCs, especially under proliferative conditions.     

The structure of aggrecan fragments in human synovial fluid. Evidence for the involvement in osteoarthritis of a novel proteinase which cleaves the Glu 373-Ala 374 bond of the interglobular domain.

Synovial fluid was collected from patients with recent knee injury and from patients with early or late stage osteoarthritis. Chondroitin sulfate-substituted aggrecan fragments present in these fluids, and in normal bovine synovial fluid, were purified by cesium chloride gradient centrifugation, enzymically deglycosylated and fractionated by gel filtration on Superose-12. Each sample contained two major aggrecan core protein populations with apparent molecular masses of approximately 90 kD and 150 kD. For all samples, NH2-terminal analysis of both populations gave a single major sequence beginning ARGSV. This NH2 terminus results from cleavage of the human aggrecan core protein at the Glu 373-Ala 374 bond within the interglobular domain between the G1 and G2 domains. Cleavage at this site also occurs during control and interleukin-1 stimulated aggrecan catabolism in bovine cartilage explant cultures (Sandy, J., P. Neame, R. Boynton, and C. Flannery. 1991. J. Biol. Chem. 266:8683-8685). These results indicate that the major aggrecan fragments present in both osteoarthritic human synovial fluid and in normal bovine synovial fluid are large, being composed of a short NH2-terminal stretch of the interglobular domain, the G2 domain, the keratan sulfate domain, and variable lengths of the chondroitin sulfate domain(s). We conclude that the release of aggrecan fragments from articular cartilage into the synovial fluid seen at all stages of human osteoarthritis (Lohmander, L. S. 1991. Acta Orthop. Scand. 62:623-632) is promoted by the action of a normal cartilage proteinase which cleaves the Glu 373-Ala 374 bond of the interglobular domain.     

The presence of cartilage matrix glycoprotein in serum as determined by immunolocation analysis is not a sensitive indicator of "early" osteoarthritis of the knee

Widespread effort is being devoted to the search for a serologic "marker" that could aid in the early diagnosis of osteoarthritis and in following the progression of the disease in response to treatment. It is obvious that such a marker would have its greatest utility in patients with mild or early osteoarthritis. CMGP is a disulfide-bonded 550,000 dalton cartilage matrix glycoprotein with a half-life of only 48 to 72 hours that has been found, through immunolocation analysis, in the serum of dogs with experimentally induced osteoarthritis and in the synovial fluid of patients with osteoarthritis but not other types of arthritis. To determine whether detection of CMGP in serum might be of value in identifying patients with "early" osteoarthritis, we examined serum samples from 26 patients with knee pain who had articular cartilage lesions of osteoarthritis at arthroscopy but whose knee radiographs were normal or showed only mild or moderate osteoarthritis. CMGP was identified by immunolocation analysis with specific antibodies. Eleven patients (42%) were seropositive for CMGP. In two, the degenerative cartilage lesions visualized at arthroscopy were mild (grade 2); in the other nine they were more severe (grade 3 or 4). However, 10 of the 15 seronegative patients also had grade 3 or 4 cartilage degeneration. Thus, this serum assay for CMGP was often negative in this group of patients in the presence of well-defined cartilage degeneration.     

大鼠高强度运动后的软骨损伤及寡聚基质蛋白的表达

目的探讨高强度运动对大鼠关节软骨及大鼠膝关节液软骨寡聚基质蛋白(COMP)表达的影响。方法将20只SD大鼠随机分为对照组和高强度运动组各10只。高强度运动组进行8周高强度跑台运动。对照组不进行运动跑台。8周后取大鼠股骨髁病理学检查,采用酶联免疫吸附法检测大鼠关节液中COMP水平。结果高强度运动组大鼠膝关节出现关节软骨损伤表现,关节液中COMP的表达高于对照组(P0.05)。结论高强度运动导致的关节软骨损伤,创伤性关节炎与COMP水平有关。     

A unique ectonucleotide pyrophosphohydrolase associated with porcine chondrocyte-derived vesicles.

Previous studies have shown increased nucleotide pyrophosphohydrolase (EC 3.6.1.8) (NTPPHase) activity in detergent extracts of degenerated human cartilage containing calcium pyrophosphate dihydrate (CPPD) crystals relative to those from osteoarthritis or normal cartilage. NTPPHase was later shown to be an ectoenzyme and its activity was increased in synovial fluid from patients with CPPD crystal deposits relative to fluids from other types of arthritis. We have purified a soluble 61-kD NTPPHase from conditioned media of organ-cultured porcine articular cartilage to electrophoretic homogeneity. Its NH2-terminal sequence through 26 cycles showed < 30% homology to any previously reported protein sequence. An antibody raised to a synthetic peptide corresponding to this sequence reacted with denatured but not native enzyme. This antibody reacted against a sedimentable vesicle-associated 127-kD protein in conditioned media from cultured articular cartilage or from chondrocytes in primary monolayer culture and against a series of soluble proteins in conditioned media supernatant, including a 61-kD protein representing our original isolate. No reactivity was found in 1% SDS extracts of washed cultured chondrocytes, although these contained greater NTPPHase activity than the conditioned media. Antibody to PC-1, another ectoNTPPHase, reacted with 1% SDS extracts of whole chondrocytes but not against those chromatographic fractions containing the major portion of NTPPHase activity. Release of the vesicle-associated 127-kD enzyme into conditioned medium was stimulated three- to sevenfold by TGF beta 1. The antibody also reacted with a series of soluble proteins and with 127-kD sedimentable protein in human synovial fluid. Kinetic studies supported the existence of a unique vesicle-associated NTPPHase; apparent Km (mM) of chondrocyte membrane NTPPHase was 1.5 and 3.0 at pH 7.3 and 9.88, respectively; apparent Km (mM) of vesicle associated NTPPHase was 0.83 and 1.28 at pH 7.3 and 9.88. The data suggest the existence of a unique ecto-NTPPHase associated with vesicles derived from normal articular cartilage.     

Stimulation of pyrophosphate production in articular cartilage by a platelet-derived factor is independent of mitogenesis

The disordered production of extracellular inorganic pyrophosphate (PPi) by cartilage contributes to calcium pyrophosphate dihydrate crystal formation and associated diseases. We have previously shown that a factor(s) derived from human platelets markedly stimulates the accumulation of PPi in the media of porcine articular cartilage in organ culture. This is the first known physiologic modifier of PPi production by cartilage. We report herein that platelet derived growth factor (PDGF) is not the platelet factor responsible for PPi stimulation and that the active factor is not mitogenic for chondrocytes. PDGF added to the media of articular cartilage explants in the presence of 0.5% (platelet-poor) plasma (PPP) produces 3.92 +/- 1.6 mumol/L PPi compared with 2.85 +/- 0.7 mumol/L PPi in cartilage exposed to PPP alone. The platelet extract (PE) and PDGF are mitogenic for adult articular chondrocytes in high-density monolayer cultures. Anti-PDGF antibodies block the mitogenic effects of PDGF and PE. The uptake of thymidine labeled with tritium is 157% of control in cells exposed to PE, PPP, and polyclonal goat immunoglobulin G (IgG); 114% of control in cells exposed to PE, PPP, and anti-PDGF antibody; 148% of control in cells treated with PDGF, PPP, and goat IgG; and 98% of control in cells treated with PDGF, PPP, and anti-PDGF antibody. However, anti-PDGF antibody has no effect on PPi accumulation. PPi levels are 17.22 +/- 1.6 mumol/L in media from cartilage treated with PPP, goat IgG, and PE and 17.62 +/- 2.2 mumol/L in cartilage exposed to PE, PPP, and anti-PDGF antibody. We have further characterized the platelet factor responsible for the stimulation of PPi by cartilage. It is not mitogenic for chondrocytes, and it is not PDGF.     

VEGF治疗退变性膝关节炎的动物实验研究

目的通过观察血管内皮生长因子（VEGF）对动物膝骨关节炎（OA）软骨的影响,探讨OA的发病机制及VEGF不同给药方式对其治疗作用。方法20只新西兰大白兔随机分为4组：正常对照组（A组）,模型对照组（B组）,VEGF膝关节腔注射组（C组）,VEGF腹腔注射组（D组）。手术建立OA模型,第8天开始D组腹腔注射VEGF每天1次,C组关节腔每7d注射VEGF1次,给药12周后处死动物,切取胫骨平台关节软骨大体观察,行苏木精-伊红染色及甲苯胺蓝染色检查,检测血清、关节液及滑膜中超氧化物歧化酶（SOD）、丙二醛（MDA）和一氧化氮（NO）。结果A组动物模型关节软骨正常;B、D两组动物模型关节软骨缺损部分修复;C组动物模型关节软骨缺损完全修复。与B组比较,C组关节软骨形态学上明显改善,血清及关节液中SOD明显升高（F=11.43,P〈0.01）,NO、MDA均明显降低（F=16.23,P〈0.01）,而D组则未见明显改善。结论VEGF能有效防治实验性OA;关节腔注射VEGF治疗OA的疗效明显优于腹腔注射。     

INCREASED FIXATION OF SULFUR35 BY CARTILAGE IN VITRO FOLLOWING DEPLETION OF THE MATRIX BY INTRAVENOUS PAPAIN

The uptake in vitro of sulfur-35 by costal cartilage obtained from nine rabbits 11 days after an intravenous injection of crude papain solution was compared with that in costal cartilage from eight normal untreated rabbits. An increased fixation of the isotope was found in treated animals compared with controls. The depletion of cartilage matrix by papain provided an experimental situation to test the hypothesis that the depletion of matrix which occurs in osteoarthritic cartilage can stimulate increased synthesis of chondroitin sulfate. The results give further support to the view that the primary lesion in osteoarthritis occurs in the matrix rather than in the chondrocyte of articular cartilage.     

高强度跑台运动对大鼠膝关节液软骨寡聚基质蛋白水平影响

目的探讨高强度运动对大鼠关节液软骨寡聚基质蛋白（cartilage oligomeric matrix protein,COMP）及关节软骨的影响。方法 SD大鼠20只随机分为对照组和高强度运动组各10只,高强度运动组行8周高强度跑台运动,对照组不进行运动训练;8周后取大鼠股骨髁软骨行组织病理学检查观察其组织学变化,采用ELISA法检测2组大鼠关节液COMP水平。结果高强度运动组大鼠膝关节出现不同关节软骨损伤的表现,关节液COMP水平（（14.1±2.3）μg/L）明显高于对照组（（5.6±1.4）μg/L））（P〈0.05）。结论高强度运动可造成关节软骨损伤,关节液中COMP表达水平与创伤性关节炎发生有关。     

An Ultrasound Biomicroscopic and Water Jet Ultrasound Indentation Method for Detecting the Degenerative Changes of Articular Cartilage in a Rabbit Model of Progressive Osteoarthritis

It is important to assess the early degeneration of articular cartilage associated with osteoarthritis (OA) for early intervention and treatment planning. Previously, we have developed a high frequency ultrasound and water jet indentation method for the morphologic, acoustic and mechanical assessment of articular cartilage, using the enzymatic digestion as a model of osteoarthritic degeneration. No naturally degenerated articular cartilage has been tested with the developed method. In this study, we aimed to determine the usefulness of the developed method for detecting the natural degeneration of articular cartilage in a standard surgical model of OA in rabbits. Forty adult New Zealand white female rabbits were used in this study, which included 30 experimental rabbits undergoing the right anterior cruciate ligament transection surgery and 10 control rabbits. At the 3^rd, 6^th, and 9^th week post-surgery, 10 experimental rabbits were sacrificed, respectively, for assessment of the knee cartilage quality. The cartilage at the medial and lateral femoral condyles and tibial plateaus (four points) was measured by the high frequency ultrasound biomicroscopy, the water jet ultrasound indentation and a contact mechanical indentation test before a histopathologic analysis for grading of degeneration severity. Measured parameters were compared among different groups classified either by post-surgery time or by histopathologic grade. The results showed a general trend of increase for ultrasound roughness index and a general trend of decrease for integrated reflection coefficient, stiffness coefficient from water-jet indentation and Young's modulus (E) from the mechanical indentation with the increase of post-surgery time. Comparisons among groups with different histopathologic grades showed similar trend with the increase of degeneration severity. The water jet ultrasound indentation method was demonstrated to be an effective method to measure the mechanical properties of the articular cartilage and with further development of arthroscopic ultrasound probe; it has the ability to assess the early degeneration of articular cartilage with measurement of morphologic, acoustic and mechanical properties of the cartilage in vivo.     

正常关节软骨和骨关节炎关节软骨细胞中血管活性肠肽表达的比较

背景:神经肽的发现给骨关节炎的治疗带来了新的希望,但神经肽的表达与骨关节炎发病以及软骨退变程度的关系尚不清楚。目的:观察血管活性肠肽在正常关节软骨和不同退变程度骨关节炎软骨中的表达,以及血管活性肠肽表达与骨关节炎发病及软骨退变程度的关系。方法:选取2007-03/11中南大学湘雅医院骨科进行关节置换的骨关节炎患者的关节软骨标本26个,选取因外伤行截肢的膝关节软骨或股骨颈暴力骨折的股骨头正常关节软骨标本10个为对照,根据大体观察凿取正常和骨关节炎不同退变程度软骨块50个,再根据关节软骨改良Mankin病理评分法进行分组,采用免疫组织化学染色检测软骨组织中血管活性肠肽的表达和分布。结果与结论:各关节软骨中均可见到血管活性肠肽阳性神经纤维,正常关节软骨中血管活性肠肽的表达明显高于骨关节炎关节软骨(P<0.05)。且血管活性肠肽表达与软骨改良Mankin病理评分呈负相关(r=-0.896,P<0.05)。说明血管活性肠肽低表达与关节软骨退变程度、骨关节炎病程进展有关,可能是关节软骨退变、骨关节炎发病的机制之一。     

正常关节软骨和骨关节炎关节软骨细胞中血管活性肠肽表达的比较

背景：神经肽的发现给骨关节炎的治疗带来了新的希望,但神经肽的表达与骨关节炎发病以及软骨退变程度的关系尚不清楚。目的：观察血管活性肠肽在正常关节软骨和不同退变程度骨关节炎软骨中的表达,以及血管活性肠肽表达与骨关节炎发病及软骨退变程度的关系。方法：选取2007-03/11中南大学湘雅医院骨科进行关节置换的骨关节炎患者的关节软骨标本26个,选取因外伤行截肢的膝关节软骨或股骨颈暴力骨折的股骨头正常关节软骨标本10个为对照,根据大体观察凿取正常和骨关节炎不同退变程度软骨块50个,再根据关节软骨改良Mankin病理评分法进行分组,采用免疫组织化学染色检测软骨组织中血管活性肠肽的表达和分布。结果与结论：各关节软骨中均可见到血管活性肠肽阳性神经纤维,正常关节软骨中血管活性肠肽的表达明显高于骨关节炎关节软骨（P〈0.05）。且血管活性肠肽表达与软骨改良Mankin病理评分呈负相关（r=-0.896,P〈0.05）。说明血管活性肠肽低表达与关节软骨退变程度、骨关节炎病程进展有关,可能是关节软骨退变、骨关节炎发病的机制之一。     

粘弹性物质补充疗法在慢性骨关节炎治疗中的应用

在关节软骨保护以及粘弹性物质补充新概念的指导下,透明质酸这一新型生物制品的应用为临床治疗慢性关节炎特别是骨关节炎提供了一种新的方法。动物实验和临床研究表明,透明质酸制剂具有良好的生物相容性而无明显副作用,能在体内完全代谢。以外源性高分子量透明质酸制剂关节内注射不仅可以提高关节内透明质酸的绝对含量,发挥其在软骨基质代谢中的作用,而且可以模拟关节滑液的物理作用,从而保护关节软骨、缓解关节疼痛、预防关节粘连、减缓关节退变的进程。     

Expression of 92-kD type IV collagenase/gelatinase (gelatinase B) in osteoarthritic cartilage and its induction in normal human articular cartilage by interleukin 1.

We report here that a 92-kD gelatinolytic metalloproteinase is expressed as protein and mRNA in human osteoarthritic cartilage, but not in normal adult articular cartilage. Western immunoblotting demonstrated that the 92-kD gelatinolytic activity corresponded to 92-kD type IV collagenase/gelatinase (gelatinase B); mRNA for gelatinase B was identified by Northern blotting. Chondrocytes from normal cartilage also exhibited mRNA for 72-kD type IV collagenase/gelatinase (gelatinase A), tissue collagenase, and stromelysin-1, and these mRNAs were increased in osteoarthritic cartilage. Regional analysis of osteoarthritic cartilage samples from four individuals revealed that gelatinase B mRNA was expressed in grossly fibrillated areas; two of four nonfibrillated cartilage samples failed to exhibit the mRNA, but did have increased levels of mRNA for other neutral metalloproteinases. IL-1 alpha treatment of normal human cartilage explants or isolated chondrocytes induced increased levels of gelatinase B and increased mRNA for tissue collagenase and stromelysin-1. Under identical conditions, mRNA levels for gelatinase A were not increased indicating that regulation of this enzyme in human articular chondrocytes is distinct from that of other metalloproteinases. Our data showing expression of gelatinase B in fibrillated cartilage suggest that it is a marker of progressive articular cartilage degradation in osteoarthritis.     

鹿茸多肽干预膝骨性关节炎软骨细胞的增殖

背景：软骨细胞体外培养实验证实,鹿茸多肽其具有显著的促细胞有丝分裂活性,可刺激软骨细胞的增殖。目的：观察鹿茸多肽对实验性骨性关节炎相关细胞因子的调节作用和对软骨细胞增殖的影响。方法：将新西兰大白兔随机分成正常组,假手术组和模型组。正常组不予任何处理,假手术组左膝关节内侧皮肤切开后缝合,模型组建立左膝骨性关节炎模型。模型组建模成功后再将随机分为2组,鹿茸多肽组给予鹿茸多肽针剂生理盐水稀释液关节腔注射干预,生理盐水组给予生理盐水关节腔注射作为对照,干预后第1,7,15,30天分别观察鹿茸多肽组和生理盐水组关节软骨形态学变化和软骨细胞结构变化;酶联免疫吸附法检测关节液中白细胞介素1β,肿瘤坏死因子α和转化生长因子β1的水平,免疫组织化学法检测关节软骨增殖细胞核抗原表达并计算细胞增殖指数。结果与结论：在相同时间段内,与生理盐水组相比,鹿茸多肽组关节软骨增殖细胞核抗原表达,细胞增殖指数及关节液中转化生长因子β1含量均增高（P〈0.05）,关节液中白细胞介素1β和肿瘤坏死因子α水平明显降低（P〈0.05）。结果证实鹿茸多肽可降低实验性骨性关节炎过程中白细胞介素1β和肿瘤坏死因子α水平,提高转化生长因子β1水平,并可促进关节软骨细胞的增殖。     

电针抑制骨性关节炎的炎症反应及延缓关节软骨退变

背景:研究表明电针能有效缓解骨性关节炎的临床症状。目的:观察电针抑制骨性关节炎的炎症反应及保护关节软骨的作用机制。方法:采用木瓜蛋白酶双膝关节腔注射复制SD大鼠骨性关节炎模型,建模成功后分别电针内、外膝眼(EX-LE4,EX-LE5)治疗5,15,30min/d。结果与结论:与模型组比较,经电针15,30min/d治疗的骨性关节炎模型大鼠血液中P物质及关节液中白细胞介素1、白细胞介素6、肿瘤坏死因子α和基质金属蛋白酶3的质量浓度明显减少(P<0.05),血液中瘦素及关节液中基质金属蛋白酶抑制因子1的水平明显增加(P<0.05),同时软骨退变的程度明显减轻(P<0.05,P<0.01)。证实电针能有效减轻大鼠膝骨性关节炎的炎症反应,延缓关节软骨的退变。