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双膦酸盐对犬骨关节炎十字韧带损伤模型骨组织形态计量学及动力学的影响。

Effects of a bisphosphonate on bone histomorphometry and dynamics in the canine cruciate deficiency model of osteoarthritis.

作者信息

Myers S L, Brandt K D, Burr D B, O'Connor B L, Albrecht M

机构信息

Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.

出版信息

J Rheumatol. 1999 Dec;26(12):2645-53.

Abstract

OBJECTIVE

To examine the effect of the bisphosphonate NE- 10035 on bone histomorphometry and bone dynamics in dogs after transection of the anterior cruciate ligament (ACL), and to determine, in a placebo controlled trial, whether treatment modified the severity of pathologic changes of osteoarthritis (OA) in the unstable joint.

METHODS

Ten adult male mongrel dogs underwent ipsilateral ACL transection. Five dogs then received daily subcutaneous injections of NE-10035 on 5 days per week for 12 weeks beginning the day after surgery. The other 5 dogs served as concurrent OA controls and received subcutaneous injections of saline on the same schedule. At sacrifice, 12 weeks after ACL transection, the articular cartilage and synovium of both knees of each dog were evaluated grossly and histologically and the water content and uronic acid concentration of the articular cartilage was determined. Fifteen days before sacrifice, each dog was injected with the fluorochrome label calcein. The injection regimen was repeated 10 days after the initial date. At sacrifice, static and dynamic variables of bone formation were assessed and bone resorption was quantified.

RESULTS

In the OA knee of the control group, bone formation and resorption were markedly increased. NE-10035 markedly reduced both formation and resorption of cancellous subchondral bone, but had no effect on osteophyte formation or pathologic changes of OA in the articular cartilage, which were mild in both treatment groups. Water content of the OA cartilage was increased by about 8% in both treatment groups. However, among the controls, the mean uronic acid concentration of the OA cartilage was increased by about 30% in comparison with values for the contralateral knee, while in the NE-10035 treatment group the mean uronic acid concentration of OA knee cartilage was about 15% lower in the active treatment group than in cartilage from the contralateral knee (p = 0.003 for the difference in OA knee uronic acid concentration between the 2 treatment groups, relative to that in the contralateral knee).

CONCLUSION

The antiresorptive agent employed in this study effectively reduced turnover of subchondral bone in the OA joint, consistent with the coupling of bone formation to bone resorption at that site. Nonetheless, over the 12 week period of the study it had no effect on osteophyte formation, in which bone formation occurs via enchondral ossification and is not linked to bone resorption, and, despite the clear inhibition of bone turnover in the OA knee of the active treatment group, did not affect the severity of cartilage changes of OA. It should be noted, however, that although treatment with this antiresorptive agent did not affect the level of chondropathy, the cartilage changes in both treatment groups were relatively mild and the sample size relatively small. Additional studies with a larger number of animals and a longer period of observation (to increase the severity of pathology) are warranted to determine whether the inhibition of bone turnover and the decrease in proteoglycan concentration that resulted from therapy will affect articular cartilage degeneration in the OA joint.

摘要

目的

研究双膦酸盐NE - 10035对犬前交叉韧带(ACL)横断后骨组织形态计量学和骨动力学的影响,并在一项安慰剂对照试验中确定该治疗是否改变了不稳定关节中骨关节炎(OA)病理变化的严重程度。

方法

10只成年雄性杂种犬接受同侧ACL横断。其中5只犬在术后次日开始,每周5天皮下注射NE - 10035,持续12周。另外5只犬作为同期OA对照,按相同方案皮下注射生理盐水。在ACL横断12周后处死动物,对每只犬双膝关节的关节软骨和滑膜进行大体和组织学评估,并测定关节软骨的含水量和糖醛酸浓度。在处死前15天,每只犬注射荧光染料钙黄绿素。初始注射10天后重复该注射方案。处死时,评估骨形成的静态和动态变量并量化骨吸收。

结果

在对照组的OA膝关节中,骨形成和吸收明显增加。NE - 10035显著降低了松质骨软骨下骨的形成和吸收,但对骨赘形成或关节软骨的OA病理变化没有影响,两个治疗组的这些变化均较轻。两个治疗组中OA软骨的含水量均增加了约8%。然而,在对照组中,与对侧膝关节相比,OA软骨的平均糖醛酸浓度增加了约30%,而在NE - 10035治疗组中,OA膝关节软骨的平均糖醛酸浓度比来自对侧膝关节的软骨低约15%(两组治疗组OA膝关节糖醛酸浓度相对于对侧膝关节的差异,p = 0.003)。

结论

本研究中使用的抗吸收剂有效降低了OA关节中软骨下骨的转换,这与该部位骨形成与骨吸收的耦合一致。尽管如此,在为期12周的研究中,它对骨赘形成没有影响,骨赘形成是通过软骨内成骨发生的,与骨吸收无关,并且,尽管在积极治疗组的OA膝关节中骨转换明显受到抑制,但并未影响OA软骨变化的严重程度。然而,应该注意的是,尽管用这种抗吸收剂治疗没有影响软骨病的程度,但两个治疗组的软骨变化相对较轻且样本量相对较小。需要进行更多动物数量和更长观察期(以增加病理严重程度)的额外研究,以确定治疗引起的骨转换抑制和蛋白聚糖浓度降低是否会影响OA关节中的关节软骨退变。

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