Department of Orthopedics, Clinical Sciences Lund, Lund University, BMC C12, Klinikgatan 28, SE-221 84 Lund, Sweden.
Arthritis Res Ther. 2010;12(6):R230. doi: 10.1186/ar3217. Epub 2010 Dec 31.
Aggrecanase cleavage at the (392)Glu-(393)Ala bond in the interglobular domain (IGD) of aggrecan, releasing N-terminal (393)ARGS fragments, is an early key event in arthritis and joint injuries. We determined whether synovial fluid (SF) levels of ARGS-aggrecan distinguish subjects with progressive radiographic knee osteoarthritis (ROA) from those with stable or no ROA.
We studied 141 subjects who, at examination A, had been given meniscectomies an average of 18 years earlier (range, 15 to 22 years). Seventeen individuals without surgery, and without known injury to the menisci or cruciate ligaments, were used as references. At examinations A and B, with a mean follow-up time of 7.5 years, we obtained SF and standing tibiofemoral and skyline patellofemoral radiographs. SF ARGS-aggrecan was measured with an electrochemiluminescence immunoassay, and we graded radiographs according to the OARSI atlas. The association between SF ARGS levels at examination A and progression of radiographic features of knee OA between examinations A and B was assessed by using logistic regression adjusted for age, gender, body mass index, and time between examinations, and stratified by ROA status at examination A.
We found a weak negative association between SF ARGS concentrations and loss of joint space: the likelihood of progression of radiographic joint space narrowing decreased 0.9 times per picomole per milliliter increase in ARGS (odds ratio (OR) 0.89; 95% confidence interval (CI), 0.79 to 0.996). In subjects with and without preexisting ROA at examination A, the association was OR, 0.96; 0.81 to 1.13; and 0.77; 0.62 to 0.95, respectively. Average levels of SF ARGS 18 years after meniscectomy were no different from those of reference subjects and were not correlated to radiographic status at examination A.
In subjects with previous knee meniscectomy but without ROA, levels of SF ARGS-aggrecan were weakly and inversely associated with increased loss of joint space over a period of 7.5 years.
聚集蛋白聚糖在连接球部（IGD）中（392）Glu-（393）Ala 键的裂解，释放 N 端（393）ARGS 片段，是关节炎和关节损伤的早期关键事件。我们确定滑液（SF）中ARGS-聚集蛋白聚糖的水平是否可以区分进展性膝关节骨关节炎（ROA）患者与稳定或无 ROA 患者。
我们研究了 141 名受试者，他们在检查 A 时平均接受了 18 年前（范围为 15 至 22 年）的半月板切除术。17 名未接受手术且半月板或十字韧带无已知损伤的个体被用作参考。在检查 A 和 B 时，平均随访时间为 7.5 年，我们获得了 SF 和站立的胫股关节和天穹髌股关节射线照片。SF ARGS-聚集蛋白聚糖使用电化学发光免疫测定法进行测量，并根据 OARSI 图谱对射线照片进行分级。使用逻辑回归调整年龄、性别、体重指数和检查之间的时间，并按检查 A 时 ROA 状态分层，评估检查 A 时 SF ARGS 水平与检查 A 和 B 之间膝关节 OA 放射特征进展之间的相关性。
我们发现 SF ARGS 浓度与关节间隙丢失之间存在弱负相关：ARG 每增加 1 皮摩尔/毫升，放射学关节间隙狭窄进展的可能性降低 0.9 倍（比值比（OR）0.89；95%置信区间（CI），0.79 至 0.996）。在检查 A 时存在和不存在预先存在的 ROA 的受试者中，该关联分别为 OR，0.96；0.81 至 1.13；和 0.77；0.62 至 0.95。半月板切除术后 18 年的 SF ARGS 平均水平与参考受试者的水平无差异，与检查 A 时的放射学状态无关。
在先前接受过膝关节半月板切除术但无 ROA 的受试者中，SF ARGS-聚集蛋白聚糖水平与 7.5 年内关节间隙丢失的增加呈弱负相关。
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