Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands.
Osteoarthritis Cartilage. 2009 Apr;17(4):433-40. doi: 10.1016/j.joca.2008.09.001. Epub 2008 Oct 14.
Joint bleeding leads to joint destruction. In vitro exposure of human and canine cartilage to blood results in long-lasting severe adverse changes in cartilage. An in vivo joint haemorrhage in the canine knee joint demonstrates similar adverse effects although significantly less outspoken. As a possible explanation for this discrepancy, we studied the clearance rate of blood from the canine knee joints.
Blood was injected into the knee joint of Beagle dogs either 48 h, 24h or 15 min before termination. The amount of red blood cells (RBC) and white blood cells (WBCs) present in the joint cavity was determined. Chondrocyte activity and cartilage matrix integrity as well as cartilage destructive activity of synovial tissue were determined biochemically. Additionally, synovial tissue was analyzed by use of histochemistry.
The amount of blood was decreased to <5% within 48 h. Within this time period the cartilage was negatively affected and the synovial tissue showed cartilage destructive activity. Evaluation of the synovial tissue 15 min post-injection revealed countless numbers of intact RBC that were almost completely disappeared after 48 h without significant recruitment of macrophages.
Blood is cleared very rapidly from the canine knee joint, but already has adverse effects on both cartilage and synovial tissue within that short time span. This rapid clearance can play a role in the discrepancy between long-term in vitro and in vivo effects of blood-induced joint damage since more than 10% v/v blood present for at least 48 h is needed to induce long-term adverse effects in vitro.
关节出血会导致关节破坏。将人或犬的软骨体外暴露于血液中会导致软骨长期严重的不良变化。尽管犬膝关节内的关节内出血表现出的不良反应不那么明显,但也存在类似的不良反应。为了解释这种差异,我们研究了犬膝关节内血液的清除率。
在处死前 48 小时、24 小时或 15 分钟,将血液注入比格犬的膝关节内。检测关节腔中存在的红细胞(RBC)和白细胞(WBC)的数量。通过生化方法检测软骨细胞活性、软骨基质完整性和滑膜组织的软骨破坏活性。此外,还使用组织化学方法分析滑膜组织。
48 小时内血液量减少至<5%。在这段时间内,软骨受到负面影响,滑膜组织显示出软骨破坏活性。注射后 15 分钟对滑膜组织的评估显示,大量完整的 RBC 存在,在 48 小时后几乎完全消失,而巨噬细胞的募集并不明显。
犬膝关节内的血液清除速度非常快,但在如此短的时间内,已经对软骨和滑膜组织产生了不良影响。这种快速清除可能在血液引起的关节损伤的长期体外和体内效应之间的差异中起作用,因为体外诱导长期不良反应至少需要存在 48 小时、体积比为 10%以上的血液。