Hembry R M, Dyce J, Driesang I, Hunziker E B, Fosang A J, Tyler J A, Murphy G
School of Biological Sciences, University of East Anglia, Norwich, United Kingdom.
J Bone Joint Surg Am. 2001 Jun;83(6):826-38. doi: 10.2106/00004623-200106000-00003.
Partial-thickness defects in mature articular cartilage do not heal spontaneously. Attempts at repair often result in limited integration between the repair tissue and the surrounding cartilage, with formation of chondrocyte clusters adjacent to a zone of cartilage necrosis. In wound repair, spatially and temporally controlled expression of matrix metalloproteinases and their inhibitors have been implicated in proteolytic degradation of damaged extracellular matrix components, but the sequence of events following damage to cartilage is unknown. To determine this sequence, we studied the distribution of matrix metalloproteinases and their inhibitors during early in vivo repair of partial-thickness defects in pig articular cartilage.
With use of a model that elicits the ingrowth of mesenchymal cells into partial-thickness defects, partial-thickness defects were created in knee joint cartilage. The distributions of matrix metalloproteinase-1, 2, 3, 9, 13, and 14; tissue inhibitors of metalloproteinase-1 and 2; and the neoepitope DIPEN341 specifically generated following matrix metalloproteinase cleavage of aggrecan were determined by immunolocalization of repair tissue and surrounding cartilage excised from immature pigs during the first eight weeks of repair and from adult minipigs at eight days and three weeks.
Synthesis of matrix metalloproteinase-13 was usually confined to hypertrophic chondrocytes in immature cartilage and to the radial zone in adult cartilage. Following injury, strong induction of matrix metalloproteinase-13 synthesis was observed in chondrocyte clusters surrounding lesions in all of the animals. The migration of macrophages into defects was prominent at two and eight days, with synthesis and deposition of matrix metalloproteinase-9 onto damaged cartilage matrix and newly synthesized matrix in the defect. The DIPEN341 neoepitope was localized to damaged cartilage matrix at eight days and six weeks, indicating partial degradation of aggrecan. Focal synthesis of matrix metalloproteinase-1, 3, and 14 and of tissue inhibitor of metalloproteinase-1 occurred at later times, suggesting continuous remodeling of the increasingly compact repair tissue.
The expression of matrix metalloproteinase-13 by normal hypertrophic chondrocytes and the induction of synthesis in chondrocyte clusters adjacent to the zone of cartilage necrosis suggest that this enzyme participates in the pericellular proteolysis required for lacunar expansion. The localization of matrix metalloproteinase-9 to damaged cartilage matrix suggested matrix proteolysis, which was confirmed with DIPEN341 localization. Reduced matrix metachromasia persisted and was colocalized with DIPEN341 at six weeks. However, under the conditions investigated, there was only limited proteolytic degradation in the zone of cartilage necrosis. This may render the zone mechanically weakened, thereby contributing to subsequent instability of the region, and may form a barrier to integration of repair tissue with viable cartilage.
Osteoarthritis initially involves the superficial layers of cartilage. The development of procedures to promote the healing or repair of early defects will have major advantages in terms of disease alleviation as well as economic importance. Identification of the enzymes involved in the early repair of partial-thickness defects in articular cartilage is clinically relevant because proteolysis of damaged matrix has to take place in order for repair tissue to integrate with surrounding healthy cartilage.
成熟关节软骨的部分厚度缺损不会自发愈合。修复尝试往往导致修复组织与周围软骨之间的整合有限,在软骨坏死区域附近形成软骨细胞簇。在伤口修复中,基质金属蛋白酶及其抑制剂在空间和时间上的受控表达与受损细胞外基质成分的蛋白水解降解有关,但软骨损伤后的事件顺序尚不清楚。为了确定这个顺序,我们研究了猪关节软骨部分厚度缺损早期体内修复过程中基质金属蛋白酶及其抑制剂的分布。
使用一种促使间充质细胞长入部分厚度缺损的模型,在膝关节软骨中制造部分厚度缺损。通过对修复组织和从幼年猪修复的前八周以及成年小型猪在八天和三周时切除的周围软骨进行免疫定位,确定基质金属蛋白酶-1、2、3、9、13和14;金属蛋白酶组织抑制剂-1和2;以及在聚集蛋白聚糖被基质金属蛋白酶切割后特异性产生的新表位DIPEN341的分布。
基质金属蛋白酶-13的合成通常局限于未成熟软骨中的肥大软骨细胞和成年软骨中的放射状区域。损伤后,在所有动物损伤周围的软骨细胞簇中观察到基质金属蛋白酶-13合成的强烈诱导。巨噬细胞在第2天和第8天显著迁移到缺损处,基质金属蛋白酶-9合成并沉积在受损软骨基质和缺损处新合成的基质上。DIPEN341新表位在第8天和第6周定位于受损软骨基质,表明聚集蛋白聚糖部分降解。基质金属蛋白酶-1、3和14以及金属蛋白酶组织抑制剂-1的局灶性合成在较晚时间发生,表明越来越致密的修复组织不断重塑。
正常肥大软骨细胞表达基质金属蛋白酶-13以及在软骨坏死区域附近的软骨细胞簇中合成诱导表明,该酶参与了陷窝扩张所需的细胞周围蛋白水解。基质金属蛋白酶-9定位于受损软骨基质表明存在基质蛋白水解,这通过DIPEN341定位得到证实。在第6周,基质异染性降低持续存在并与DIPEN341共定位。然而,在所研究的条件下,软骨坏死区域的蛋白水解降解有限。这可能使该区域机械性减弱,从而导致该区域随后的不稳定,并可能形成修复组织与存活软骨整合的障碍。
骨关节炎最初累及软骨表层。开发促进早期缺损愈合或修复的方法在减轻疾病以及经济重要性方面将具有重大优势。鉴定参与关节软骨部分厚度缺损早期修复的酶具有临床相关性,因为受损基质的蛋白水解必须发生,以便修复组织与周围健康软骨整合。