Qi Chang, Changlin Huang
Orthopedics Institute, Xijing Hospital of PLA, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
J Surg Res. 2006 Oct;135(2):352-63. doi: 10.1016/j.jss.2006.03.011. Epub 2006 Aug 14.
To study the adaptation process and extent of articular cartilage in the canine knee joint to different modes of movements and to investigate if levels of cartilage oligomeric matrix protein (COMP), matrix metalloproteinases-1 (MMP-1), matrix metalloproteinases-3 (MMP-3), and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in serum and synovial fluid can be used to predict effectively early sports injury and remolding degree of articular cartilage in the canine knee.
Twenty adult dogs divided randomly into three groups (eight in the common training group, Training Group; eight in the intensified training group, Intensified Group; and four in the Control Group) were trained daily at different intensities. Magnetic resonance imaging (MRI) examinations were performed regularly (0, 2, 4, 6, 8, 10 weeks) to investigate changes of articular cartilage in the canine knee, while concentrations of COMP, MMP-1, MMP-3, and TIMP-1 in serum and synovial fluid were measured by ELISA assays. All of the dogs were euthanized after training for 10 weeks, and all of the knee joints were taken out to be examined histologically.
We could find imaging changes of early sport injury of articular cartilage in the Training Group and Intensified Group by MRI examination after 2 weeks of training; the damage images were most severe in 4-6 weeks, and then lightened gradually. We could not find the difference of cartilage injury and repair degree in MRI images between these two groups at different time points. Elevations of levels of COMP, MMP-1, MMP-3, TIMP-1, and MMP-3/TIMP-1 in serum and synovial fluid were seen during the training period, and their levels changed remarkably at different times. Levels of MMP-1, MMP-3, and MMP-3/TIMP-1 in the Intensified Group were lower than that in the Training Group in general, and levels of COMP were higher, which hinted that the injury trend of articular cartilage in the Intensified Group was lower than that in the Training group, and the repair trend was higher. Furthermore, there were statistically significant associations between biomarker levels in serum and in synovial fluid. Histological examinations in 10 weeks demonstrated that the signs of cartilage damage and repair in canine knee joint in the Training Group and the Intensified Group were obvious, and the Intensified Group could do better than the Training Group in promoting remodeling reconstruction of articular cartilage.
High-intensity and repetitive movement may easily induce sports injury, and it is followed with a repair process; intensified training can do better than common training in promoting remodeling reconstruction of articular cartilage. The sensitivity of these biomarkers reflecting articular cartilage pathological changes is better than MRI, and the associated application of several biomarkers to predict the extent of damage and repair, as well as changes of metabolism in articular cartilage, and to monitor change of disease course has very good value for clinical application.
研究犬膝关节软骨对不同运动模式的适应过程及程度,并探讨血清和滑液中软骨寡聚基质蛋白(COMP)、基质金属蛋白酶 -1(MMP -1)、基质金属蛋白酶 -3(MMP -3)和基质金属蛋白酶组织抑制剂 -1(TIMP -1)水平是否可有效预测犬膝关节早期运动损伤及软骨重塑程度。
将20只成年犬随机分为三组(普通训练组8只,训练组;强化训练组8只,强化组;对照组4只),每天进行不同强度训练。定期(0、2、4、6、8、10周)进行磁共振成像(MRI)检查,以观察犬膝关节软骨变化,同时采用酶联免疫吸附测定法(ELISA)检测血清和滑液中COMP、MMP -1、MMP -3和TIMP -1的浓度。训练10周后对所有犬实施安乐死,取出所有膝关节进行组织学检查。
训练2周后,通过MRI检查可发现训练组和强化组关节软骨早期运动损伤的影像学改变;损伤图像在4 - 6周时最严重,随后逐渐减轻。不同时间点两组在MRI图像上的软骨损伤和修复程度无差异。训练期间血清和滑液中COMP、MMP -1、MMP -3、TIMP -1及MMP -3/TIMP -1水平升高,且不同时间其水平变化显著。强化组MMP -1、MMP -3及MMP -3/TIMP -1水平总体低于训练组,COMP水平较高,提示强化组关节软骨损伤趋势低于训练组,修复趋势高于训练组。此外,血清和滑液中生物标志物水平之间存在统计学显著相关性。10周时组织学检查表明,训练组和强化组犬膝关节软骨损伤和修复迹象明显,强化组在促进关节软骨重塑重建方面优于训练组。
高强度重复运动易引发运动损伤,并伴随修复过程;强化训练在促进关节软骨重塑重建方面优于普通训练。这些反映关节软骨病理变化的生物标志物敏感性优于MRI,多种生物标志物联合应用对预测关节软骨损伤和修复程度、代谢变化及监测病程变化具有很好的临床应用价值。