白细胞介素1β、肿瘤坏死因子α在膝关节原发性骨关节病发病中的作用

目的探讨白细胞介素１β（ＩＬ－１β）、肿瘤坏死因子α（ＴＮＦ－α）在膝关节原发性骨关节病（ＯＡ）发病中的作用。方法提取１６例ＯＡ患者（ＯＡ组）、５例对照者（非ＯＡ组）的关节液，采用酶联免疫吸附法（ＥＬＩＳＡ法）测定ＩＬ－１β，生物活性法（ＭＴＴ法）检测ＴＮＦ－α的水平。结果在ＯＡ组关节滑液中，ＩＬ－１β的水平均显著高于对照组（Ｐ＜０００１）；对照组的ＴＮＦ－α未能测出，而ＯＡ组ＴＮＦ－α的检出阳性率为２５％。其次，为进一步探讨滑液中上述细胞因子的产生来源，传代培养膝关节滑膜细胞并用脂多糖（ＬＰＳ）刺激，ＯＡ组（２０例）关节滑膜细胞自发分泌ＩＬ－１β的水平显著高于对照组（５例），Ｐ＜００５；ＬＰＳ刺激的条件下，ＯＡ组和对照组分泌ＩＬ－１β均显著升高，尤以ＯＡ组为著（Ｐ＜０００１）；ＴＮＦ－α在ＯＡ组中仅有两例呈阳性，对照组中均为阴性。结论ＩＬ－１β和ＴＮＦ－α在骨关节病的发病中起重要作用。ＯＡ患者滑膜细胞高水平自发性分泌ＩＬ－１β可能与其炎症发生与发展密切相关，可能是关节滑液中ＩＬ－１β的主要来源，而滑膜细胞分泌ＴＮＦ－ａ可能不是关节滑液中的主要来源。

An Investigation of the Role Played by IL-1and TNF-on the Pathogenesis of Osteoarthrosis of the Knee

Objective To study the relationship between IL-1, TNF-and pathogenesis of knee osteoarthrosis Methods IL-1and TNF-were measured concurrently in synovial fluid samples from 16 patients with osteoarthrosis(OA) and from 5 normals The determinations of IL-1were carried out using ELISA The determination of TNF-was performed by bioassay Results he concentrations of IL-1are higher in synovial fluids from OA than those from normal (P< 0001) TNF-concentrations are low and only 25%of the patients with OA could be positively detected To further define intraarticular sources of these cytokines, the ability of synoviocytes to produce IL-1and TNF-was examined Human synoviums isolated from normal (5 cases) and osteoarthritic joints (20 cases) spontaneously release IL-1when cultured in the presence of serum The levels of IL-1increase markedly when synoviocytes were stimulated by LPS either OA or normal, especially in OA It was not found that human synoviocytes were able to produce TNF-except two samples Conclusions IL-1and TNF-might be involved in regulating the pathogenesis of OA TNF-from synoviocytes might not be major source in synovial fluid Human synoviocytes are able to secret IL-1in response to physiologic and inflammatory stimuli Synoviocytes probably may increase the synovial fluid levels of IL-1, which can contribute to important manifestations of osteoarthrosis