MMP-13和Galectin-3在骨性关节炎滑膜组织中的临床意义

目的检测MMP-13和Galectin-3在骨性关节炎滑膜组织中的表达，探讨二者在骨性关节炎发病机制中的作用。方法通过关节镜获取42例骨性关节炎滑膜标本，同时选择12例非正常死亡及外伤性截肢的健康青年的滑膜组织作为对照组。采用免疫组化检测MMP-13及Galectin-3在骨性关节炎滑膜组织中的表达。结果病理观察显示骨性关节炎滑膜细胞增生，淋巴细胞及浆细胞浸润，甚至形成淋巴滤泡，同时微血管增生，管壁增厚。免疫组化结果显示：在骨性关节炎滑膜组织中，MMP-13蛋白主要表达于滑膜衬里层细胞、炎细胞、巨噬细胞样组织细胞以及少许血管内皮细胞。在正常滑膜组织中，MMP-13蛋白则主要表达于滑膜衬里层细胞。二者的阳性细胞率分别为0．387±0．042和0．053±0．019，前者的阳性表达率明显高于后者（P〈0．05）。Galectin-3蛋白在骨性关节炎组中的阳性表达主要分布于滑膜衬里层细胞及滑膜下层少许炎细胞中。Galectin-3蛋白在骨性关节炎组和对照组的阳性细胞率分别为0．267±0．044和0．046±0．021。前者的阳性表达率明显高于后者fP〈0．05）。MMP-13和Galectin-3在骨性关节炎滑膜中表达与患者年龄及性别无关（P〉0．05），而与骨性关节炎X线片临床分期有关，MMP-3与Galectin-3在滑膜中的表达均随着骨性关节炎X线片临床分期的增高而增强（P〈0．05）。结论MMP-13蛋白和Galectin-3蛋白在骨性关节炎滑膜组织中的表达显著高于正常滑膜组织，随X线片临床分期的增高而增强，表明二者参与骨性关节炎滑膜的病理过程，对滑膜炎起相互促进作用，临床检测滑膜组织中MMP-13蛋白和Galectin-3蛋白的表达有助于指导骨性关节炎的治疗及病情的评估。

The clinical significance of Matrix Metalloproteinase-13 and Galectin-3 in synovial tissues of osteoarthritis

Objective To detect the protein expressions of Matrix Metalloproteinase-13 （ MMP-13 ） and Galectin-3 in synovial tissues of osteoarthritis, and to explore their effects in the pathogenesis of osteoarthritis. Methods 42 cases of synovial specimens of osteoarthritis and 12 cases of synovial tissues from healthy young adults who died of unnatural causes or traumatic amputation （ the control group ） were obtained by arthroscopy. The protein expressions of MMP-13 and Galectin-3 in synovial tissues of osteoarthritis were detected by immunohistochemistry. Results Pathological observation showed the synovial cell hyperplasia of osteoarthritis, infiltration of lymphocytes and plasma cells, formation of lymphoid follicles, micrangium hyperplasy and pipe wall thinkening. Immunohistochemistry results showed in synovial tissues of osteoarthritis the MMP-13 protein expression mainly appeared in synovial lining layer cells, inflammatory cells, macrophages and few endothelial cells, whereas in normal synovial tissues the MMP- 13 protein expression mainly appeared in synovial lining layer cells. The positive cell rates of MMP-13 in synovial tissues of osteoarthritis and in normal synovial tissues were 0.387i0.042 and 0.053：k0.019 respectively. The positive expression rate of MMP-13 in synovial tissues of osteoarthritis was obviously higher than that in normal synovial tissues （ P〈0.05 ）. The positive expression of Galectin-3 protein in the osteoarthritis group mainly appeared in synovial lining layer cells and few inflammatory cells in the synoviale subintima. The positive cell rates of Galectin-3 protein in the osteoarthritis group and control group were 0.267±0.044 and 0.046＋0.021 respectively. The positive expression rate of Galectin-3 protein in the osteoarthritis group was obviously higher than that in the control group （ P〈0.05 ）.The protein expressions of MMP-13 and Galectin-3 in synovial tissues of osteoarthritis were not related with the age and gender of patients （ P〉0.05 ）, but were related to the osteoarthritis X-ray clinical staging. The protein expressions of MMP-13 and Galectin-3 in synovial tissues became evident with the increase of the osteoarthritis X-ray clinical staging （P〈0.05）. Conclusions The expressions of MMP-13 protein and Galectin-3 protein in synovial tissues of osteoarthritis are significantly higher than that in normal synovial tissues, which becomes evident with the increase of the X-ray clinical staging. The findings suggest that they both participate in the pathological process of synovial tissues of osteoarthritis and promote their mutual effects on synovitis. So that, they contribute to treating and assessing the condition of osteoarthritis by clinically detecting the expressions of the MMP-13 protein and Galectin-3 protein in synovial tissues.