关节腔内注射高分子量透明质酸加磷脂对实验性骨关节炎滑膜关节润滑及预防关节软骨退变的力学效应

Mechanical effects of the intraarticular administration of high molecular weight hyaluronic acid plus phospholipid on synovial joint lubrication and prevention of articular cartilage degeneration in experimental osteoarthritis.

作者信息

Kawano Tsutomu, Miura Hiromasa, Mawatari Taro, Moro-Oka Takaaki, Nakanishi Yoshitaka, Higaki Hidehiko, Iwamoto Yukihide

机构信息

Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Arthritis Rheum. 2003 Jul;48(7):1923-9. doi: 10.1002/art.11172.

DOI:10.1002/art.11172

PMID:12847686

Abstract

OBJECTIVE

To examine in vivo the effects of a mixture of high molecular weight hyaluronic acid (HA) plus phospholipids on joint lubrication and articular cartilage degeneration.

METHODS

Experimental osteoarthritis (OA) of the right knee was induced by anterior cruciate and medial collateral ligament transection in 40 rabbits. The animals were subjected to 8 consecutive weekly intraarticular administrations of high molecular weight HA (the HA200 group), conventional molecular weight HA (the HA80 group), or high molecular weight HA plus L-delta dipalmitoyl phosphatidylcholine liposomes (the PHA group) and were killed 1 week after the final injection. The remaining transected right knees (the OA group) and randomly selected nontransected contralateral left knees (the control group) were collected simultaneously. Each group (n = 10) was divided into 2 equal subgroups, one of which was evaluated histologically while the other was subjected to a lubricating ability test using a pendulum friction tester.

RESULTS

The injected knees had a tendency to demonstrate less damage to the articular cartilage compared with the OA group, and the histologic findings in all groups except for the PHA group differed significantly from the control group. There was a significant difference in the mean +/- SD friction coefficient between the control group (0.0100 +/- 0.00300) and the OA (0.0206 +/- 0.00649), HA200 (0.0190 +/- 0.00427), and HA80 (0.0177 +/- 0.00712) groups (P < 0.05 for each comparison), but not between the control group and the PHA group (0.0150 +/- 0.00330) (P = 0.15).

CONCLUSION

To our knowledge, this is the first in vivo study to examine whether intraarticular injections of phospholipids influence joint lubrication by acting as a boundary lubricant, thus protecting articular cartilage from degenerative changes.

摘要

目的

在体内研究高分子量透明质酸（HA）与磷脂混合物对关节润滑及关节软骨退变的影响。

方法

通过切断40只兔的前交叉韧带和内侧副韧带诱导右侧膝关节实验性骨关节炎（OA）。对动物连续8周每周进行一次关节内注射高分子量HA（HA200组）、常规分子量HA（HA80组）或高分子量HA加L-δ-二棕榈酰磷脂酰胆碱脂质体（PHA组），并在最后一次注射后1周处死。同时收集剩余切断的右侧膝关节（OA组）和随机选取的未切断的对侧左侧膝关节（对照组）。每组（n = 10）分为2个相等的亚组，其中一个进行组织学评估，另一个使用摆锤摩擦测试仪进行润滑能力测试。

结果

与OA组相比，注射后的膝关节对关节软骨的损伤倾向较小，除PHA组外，所有组的组织学结果与对照组均有显著差异。对照组（0.0100±0.00300）与OA组（0.0206±0.00649）、HA200组（0.0190±0.00427）和HA80组（0.0177±0.00712）之间的平均±标准差摩擦系数存在显著差异（每次比较P < 0.05），但对照组与PHA组（0.0150±0.00330）之间无显著差异（P = 0.15）。