接受关节镜半月板切除术患者的滑膜炎症：分子特征及其与症状的关系。
Synovial inflammation in patients undergoing arthroscopic meniscectomy: molecular characterization and relationship to symptoms.
作者信息
Scanzello Carla R, McKeon Brian, Swaim Bryan H, DiCarlo Edward, Asomugha Eva U, Kanda Veero, Nair Anjali, Lee David M, Richmond John C, Katz Jeffrey N, Crow Mary K, Goldring Steven R
机构信息
Rush University Medical Center, Section of Rheumatology, Chicago, Illinois 60612, USA.
出版信息
Arthritis Rheum. 2011 Feb;63(2):391-400. doi: 10.1002/art.30137.
OBJECTIVE
Traumatic and degenerative meniscal tears have different anatomic features and different proposed etiologies, yet both are associated with the development or progression of osteoarthritis (OA). In established OA, synovitis is associated with pain and progression, but a relationship between synovitis and symptoms in isolated meniscal disease has not been reported. Accordingly, we sought to characterize synovial pathology in patients with traumatic meniscal injuries and determine the relationships between inflammation, meniscal and cartilage pathology, and symptoms.
METHODS
Thirty-three patients without evidence of OA who were undergoing arthroscopic meniscectomy for meniscal injuries were recruited. Pain and function were assessed preoperatively; meniscal and cartilage abnormalities were documented at the time of surgery. Inflammation in synovial biopsy specimens was scored, and associations between inflammation and clinical outcomes were determined. Microarray analysis of synovial tissue was performed, and gene expression patterns in patients with and those without inflammation were compared.
RESULTS
Synovial inflammation was present in 43% of the patients and was associated with worse preoperative pain and function scores, independent of age, sex, or cartilage pathology. Microarray analysis and real-time polymerase chain reaction revealed a chemokine signature in synovial biopsy specimens with increased inflammation scores.
CONCLUSION
Our findings indicate that in patients with traumatic meniscal injury undergoing arthroscopic meniscectomy without radiographic evidence of OA, synovial inflammation occurs frequently and is associated with increased pain and dysfunction. Synovia with increased inflammation scores exhibit a unique chemokine signature. Chemokines may contribute to the development of synovial inflammation in patients with meniscal pathology; they also represent potential therapeutic targets for reducing inflammatory symptoms.
目的
创伤性和退变性半月板撕裂具有不同的解剖特征和不同的病因假说，但两者均与骨关节炎（OA）的发生或进展相关。在已确诊的OA中，滑膜炎与疼痛及病情进展相关，但孤立性半月板疾病中滑膜炎与症状之间的关系尚无报道。因此，我们试图描述创伤性半月板损伤患者的滑膜病理学特征，并确定炎症、半月板和软骨病理学与症状之间的关系。
方法
招募33例无OA证据且因半月板损伤接受关节镜下半月板切除术的患者。术前评估疼痛和功能；手术时记录半月板和软骨异常情况。对滑膜活检标本中的炎症进行评分，并确定炎症与临床结果之间的关联。对滑膜组织进行微阵列分析，比较有炎症和无炎症患者的基因表达模式。
结果
43%的患者存在滑膜炎症，且与术前较差的疼痛和功能评分相关，与年龄、性别或软骨病理学无关。微阵列分析和实时聚合酶链反应显示，炎症评分增加的滑膜活检标本中有趋化因子特征。
结论
我们的研究结果表明，在无OA影像学证据且接受关节镜下半月板切除术的创伤性半月板损伤患者中，滑膜炎症频繁发生，并与疼痛加剧和功能障碍相关。炎症评分增加的滑膜表现出独特的趋化因子特征。趋化因子可能促成半月板病变患者滑膜炎症的发生；它们也代表了减轻炎症症状的潜在治疗靶点。
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