Huang Teng-Le, Hsu Horng-Chaung, Yang Kai-Chiang, Yao Chun-Hsu, Lin Feng-Huei
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, 100 Taiwan, ROC.
J Trauma. 2010 Jan;68(1):146-52. doi: 10.1097/TA.0b013e3181a92cf8.
Preventing arthritic change in a joint with an intra-articular fracture remains a challenge, especially in weight-bearing joints. Hyaluronan (HA) has been proven to be effective in relieving joint pain and improving function in chronic osteoarthritis. However, controversy still exists about its potential use in a joint with an intra-articular fracture and about whether this effect is dependent on molecular weight. We analyzed and compared the effects of two different molecular weight HAs on six osteoarthritis-related proteins expressed in fibroblast-like synoviocytes from 12 patients with tibial plateau fracture.
The interleukin (IL)-1beta-stimulated or IL-1beta-unstimulated fibroblast-like synoviocytes were cultivated with or without treatment by two different molecular weight HAs. The production of these proteins was quantified by using commercially available sandwich enzyme-linked immunosorbent assay.
The results revealed that HA with a high molecular weight is more effective in downregulating proinflammatory cytokines such as interleukin-1beta and tumor necrosis factor-alpha. Conversely, HA with a low molecular weight has greater efficacy in upregulating anticatabolic enzymes, such as tissue inhibitor of metalloproteinase-1 and tissue inhibitor of metalloproteinase-2, and in suppressing the catabolic enzyme, matrix metalloproteinase-3, which are thought to be more chondroprotective.
In a knee joint with an intra-articular fracture of the tibial plateau, we posit that high molecular weight HA may have a better anti-inflammatory effect, whereas low molecular weight HA has superior efficacy for chondroprotection.
预防关节内骨折关节的关节炎性改变仍然是一项挑战，尤其是在负重关节中。透明质酸（HA）已被证明在缓解慢性骨关节炎的关节疼痛和改善功能方面有效。然而，其在关节内骨折关节中的潜在用途以及这种效果是否依赖于分子量仍存在争议。我们分析并比较了两种不同分子量的HA对12例胫骨平台骨折患者成纤维样滑膜细胞中六种骨关节炎相关蛋白表达的影响。
将白细胞介素（IL）-1β刺激或未刺激的成纤维样滑膜细胞在有或没有两种不同分子量HA处理的情况下进行培养。使用市售的夹心酶联免疫吸附测定法定量这些蛋白的产生。
结果显示，高分子量HA在下调促炎细胞因子如白细胞介素-1β和肿瘤坏死因子-α方面更有效。相反，低分子量HA在上调抗分解代谢酶如金属蛋白酶组织抑制剂-1和金属蛋白酶组织抑制剂-2以及抑制分解代谢酶基质金属蛋白酶-3方面具有更大的功效，这些酶被认为具有更强的软骨保护作用。
在胫骨平台关节内骨折的膝关节中，我们认为高分子量HA可能具有更好的抗炎作用，而低分子量HA在软骨保护方面具有更高的功效。
