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[关节腔内注射蛋白水解酶弹性蛋白酶后健康膝关节诱发关节炎——家兔实验研究]

[Induction of arthritis in healthy knee joints after intra-articular injection of the proteolytic enzyme elastase - An experimental investigation in the rabbit].

作者信息

Blattert T R, Kunz E, Müller J, Weckbach A

机构信息

Unfall- und Wiederherstellungschirurgie, Chirurgische Universitätsklinik und Poliklinik derJulius-Maximilians-Universität Würzburg, Germany. blatterhirurgie.uni-wuerzburg.de

出版信息

Z Orthop Ihre Grenzgeb. 2002 Jan-Feb;140(1):101-5. doi: 10.1055/s-2002-22099.

Abstract

AIM

Humoral aspects are being discussed in the initiation of arthritis. Therefore, the effects of the proteolytic enzyme elastase on the cartilage of knee joints in rabbits have been investigated. The enzyme was evaluated using activities comparable to those in post-traumatic knee joint hemarthrosis in humans.

METHOD

Polymorphonuclear leukocyte elastase was injected into one of the knee joints of 10 rabbits. In 5 animals (first study group), joints were then immobilized with a cast for 6 weeks. In the other 5 (second study group), no immobilization was applied. In the first zero group (2 animals), 0.9 % NaCl was injected intra-articularly without immobilization, whereas in the second zero group (2 anmals) knees were immobilized for 6 weeks without prior injection. Thus, the effect of immobilization could be evaluated additionally. Joint specimens were then examined histologically and electron microscopically.

RESULTS

There was clear evidence of elastase having severe destructive effects on cartilage regardless of additional joint-immobilization. In neither zero group was there prearthritic damage to the cartilage.

CONCLUSION

To prevent the initiation of cartilage damage by humoral factors, early elimination of the pathological intra-articular effusion is necessary.

摘要

目的

关节炎的发病机制中体液因素备受关注。因此,研究了蛋白水解酶弹性蛋白酶对兔膝关节软骨的影响。该酶的活性评估是参照人类创伤后膝关节积血的情况。

方法

向10只兔子的一侧膝关节注射多形核白细胞弹性蛋白酶。其中5只动物(第一研究组),注射后用石膏固定关节6周。另外5只(第二研究组)不进行固定。在第一空白组(2只动物),关节腔内注射0.9%氯化钠且不固定;而在第二空白组(2只动物),膝关节固定6周但不预先注射。这样可额外评估固定的影响。之后对关节标本进行组织学和电子显微镜检查。

结果

有明确证据表明,无论是否进行额外的关节固定,弹性蛋白酶对软骨都有严重破坏作用。两个空白组的软骨均未出现关节炎前期损伤。

结论

为防止体液因素引发软骨损伤,尽早清除病理性关节内积液很有必要。

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