揉髌手法对兔膝关节软骨细胞凋亡及Bcl-2、Bax和Fas表达的影响

背景：现代研究证实细胞的过度凋亡加速软骨组织的退变,而手法的力学刺激对关节软骨影响的分子层面研究至今少有报道。目的：观察揉髌手法对兔膝关节软骨细胞凋亡及Bcl-2、Bax、Fas表达的作用。方法：50只新西兰兔随机等分为正常组、假手术组、模型组、手法组和针剂组,后3组建立右下肢骨内高压型膝关节骨性关节炎模型。造模1周后,手法组使用揉髌手法隔天治疗1次,每次10 min,共治疗5周共17次;针剂组关节内注射玻璃酸钠液0.6 mL,每周1次,共5次。结果与结论：造模后8周末取兔右膝关节内侧胫骨平台软骨组织,苏木精-伊红染色提示模型组软骨组织退变明显,软骨细胞凋亡率明显增加(P < 0.01),胫骨平台软骨组织中Bcl-2、Bax、Fas表达率明显升高(P < 0.01),而手法组和针剂组软骨组织退变轻微,软骨细胞凋亡率及Bax、Fas表达率较模型组降低(P < 0.01),但胫骨平台软骨组织中Bcl-2表达升高(P < 0.01)。说明揉髌手法与关节内注射玻璃酸钠一样可以明显降低兔膝关节软骨细胞的凋亡率,其作用机制与上调Bcl-2表达,下调Bax、Fas表达有关。

Effects of Roubin-manipulation on apoptosis of chondrocytes and expression of Bcl-2, Bax and Fas in rabbit knee joint

BACKGROUND:Modern studies have demonstrated that excessive cellular apoptosis accelerates the degeneration of cartilaginous tissue. However, effects of mechanical stimulation of manipulation on joint cartilage at the molecular level have been rarely reported. OBJECTIVE:To observe the effects of Roubin-mamipulation on apoptosis of chondrocytes and expression of Bcl-2, Bax and Fas in rabbit knee joint. METHODS:Fifty New Zealand rabbits were randomly divided into normal, sham operation, model, manipulation, and sodium hyaluronate groups. Rabbits in the latter three groups were established into high intraosseous pressure experiment model of right leg by ligating the vena femoralis and gluteae inferiors. One week later, the manipulation group received 10-minute Roubin-manipulation, once every other day, a total of 17 times within 5 weeks. The sodium hyaluronate group received intra-articular injection of 0.6 mL sodium hyaluronate, once a week, for a total of 5 times. RESULTS AND CONCLUSION:At the end of the 8th week, cartilaginous tissue of medial tibial plateau of rabbit right knee joint was harvested. Hematoxylin-eosin staining showed that compared with normal group, cartilaginous tissue degeneration was obvious, and chondrocyte apoptosis rate was significantly increased (P < 0.01), and Bcl-2, Bax and Fas expression in the tibial cartilaginous tissue was significantly increased (P < 0.01) in the model group. Compared with the model group, the cartilaginous tissue degeneration was slight, chondrocyte apoptosis rate and Bax and Fas expression were significantly decreased (P < 0.01), but Bcl-2 expression in the tibial cartilaginous tissue was significantly increased (P < 0.01) in the manipulation and sodium hyaluronate groups. Roubin-mamipulation, like intra-articular injection of sodium hyaluronate, can obviously decrease the apoptosis rate of chondrocytes in rabbit knee joint and the underlying mechanisms are related to upregulated Bcl-2 expression and downregulated Bax and Fas expression.