Kapitonova M Yu, Mansor Othman
Department ofAnatomy, School of Medical Sciences, University Sains Malaysia, Kelantan, Malaysia.
Malays J Pathol. 2003 Jun;25(1):15-27.
To determine in situ using TEM the balance of apoptosis and necrosis in the articular cartilage of patients with inflammatory (rheumatoid arthritis and seronegative spondyloarthritis) and degenerative (osteoarthritis) joint diseases and to establish possible correlation between the cell death rate and the matrix vesicles formation.
Cartilage samples of the knee joint were obtained from patients with rheumatoid arthritis (RA, 18 cases), osteoarthritis (OA, 22 cases), Reiter's disease (RD, 9 cases), peripheral form of the ankylosing spondyloarthritis (AS, 6 cases) and psoriatic arthritis (PA, 6 cases) during arthroscopy or knee surgery. Normal samples taken from autopsy cases without a history of joint diseases were used as control. Samples were processed for TEM with subsequent semi-quantitative estimation of the cell death rate in the superficial, middle and deep zone of non-calcified articular cartilage, and computer-aided ultramorphometric evaluation of the matrix vesicles of different types.
Both apoptotic and necrotic cell death could be identified in the cartilage of patients with inflammatory joint diseases, including seronegative spondyloarthritides and degenerative arthropathies. Apoptosis dominated over necrosis in all examined arthritides, including RA patients in which necrosis of the chondrocyte was the most frequent among arthropathies, while the highest apoptotic cell death rate was discovered in OA in which it correlated with the volume and numeric density of the matrix vesicles. These data provide evidence that apoptosis may contribute to the cartilage breakdown not only in RA and OA but also in the seronegative spondyloarthritides, which had a significantly higher apoptotic rate than the normal cartilage.
利用透射电子显微镜（TEM）原位测定炎症性（类风湿关节炎和血清阴性脊柱关节炎）和退行性（骨关节炎）关节疾病患者关节软骨中细胞凋亡与坏死的平衡，并确定细胞死亡率与基质小泡形成之间可能存在的相关性。
在关节镜检查或膝关节手术期间，从类风湿关节炎（RA，18例）、骨关节炎（OA，22例）、赖特综合征（RD，9例）、强直性脊柱炎外周型（AS，6例）和银屑病关节炎（PA，6例）患者获取膝关节软骨样本。取自无关节疾病病史尸检病例的正常样本用作对照。样本经处理用于TEM，随后对未钙化关节软骨的表层、中层和深层区域的细胞死亡率进行半定量评估，并对不同类型的基质小泡进行计算机辅助超微形态计量学评价。
在炎症性关节疾病患者的软骨中，包括血清阴性脊柱关节炎和退行性关节病，均可识别出凋亡和坏死性细胞死亡。在所有检查的关节炎中，凋亡均占主导地位，超过坏死，包括在所有关节病中软骨细胞坏死最常见的RA患者，而在OA中发现最高的凋亡细胞死亡率，且其与基质小泡的体积和数量密度相关。这些数据证明，凋亡可能不仅在RA和OA中导致软骨破坏，在血清阴性脊柱关节炎中也是如此，血清阴性脊柱关节炎患者软骨的凋亡率显著高于正常软骨。
