Department of Orthopaedic Surgery, Chiba Rosai Hospital, Chiba, Japan.
BMC Musculoskelet Disord. 2011 Jun 30;12:144. doi: 10.1186/1471-2474-12-144.
One of the sources of knee pain in osteoarthritis (OA) is believed to be related to local chronic inflammation of the knee joints, which involves the production of inflammatory cytokines such as tumor necrosis factor alpha (TNFα), interleukin (IL)-6, and nerve growth factor (NGF) in the synovial membrane, and these cytokines are believed to promote pathological OA. In the present study, correlations between proinflammatory cytokines in knee synovial fluid and radiographic changes and functional scores and pain scores among OA patients were examined.
Synovial fluid was harvested from the knees of 47 consecutive OA patients, and the levels of TNFα, IL-6, and NGF were measured using enzyme-linked immunosorbent assays. Osteoarthritic knees were classified using Kellgren-Lawrence (KL) grading (1-4). The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was used to assess self-reported physical function, pain, and stiffness.
TNFα and IL-6 were detectable in knee synovial, whereas NGF was not. TNFα was not correlated with the KL grade, whereas IL-6 had a significantly negative correlation. We observed differences in the correlations between TNFα and IL-6 with WOMAC scores and their subscales (pain, stiffness, and physical function). TNFα exhibited a significant correlation with the total score and its 3 subscales, whereas IL-6 exhibited a moderately significant negative correlation only with the subscale of stiffness.
The present study demonstrated that the concentrations of proinflammatory cytokines are correlated with KL grades and WOMAC scores in patients with knee OA. Although TNFα did not have a significant correlation with the radiographic grading, it was significantly associated with the WOMAC score. IL-6 had a significant negative correlation with the KL grading, whereas it had only a weakly significant correlation with the subscore of stiffness. The results suggest that these cytokines play a role in the pathogenesis of synovitis in osteoarthritic knees in different ways: TNFα is correlated with pain, whereas IL-6 is correlated with joint function.
骨关节炎 (OA) 患者膝关节疼痛的一个来源被认为与膝关节局部慢性炎症有关，这种炎症涉及滑膜中炎症细胞因子的产生，如肿瘤坏死因子-α (TNFα)、白细胞介素 (IL)-6 和神经生长因子 (NGF)，这些细胞因子被认为会促进病理性 OA 的发生。本研究旨在探讨 OA 患者膝关节滑液中促炎细胞因子与放射学改变以及功能评分和疼痛评分之间的相关性。
连续采集 47 例 OA 患者膝关节滑液，采用酶联免疫吸附试验测定 TNFα、IL-6 和 NGF 水平。采用 Kellgren-Lawrence (KL) 分级（1-4 级）对骨关节炎膝关节进行分类。采用 Western Ontario 和 McMaster 大学骨关节炎指数 (WOMAC) 评估自报告的身体功能、疼痛和僵硬程度。
TNFα 和 IL-6 可在膝关节滑液中检测到，而 NGF 则不可检测到。TNFα 与 KL 分级无相关性，而 IL-6 与 KL 分级呈显著负相关。我们观察到 TNFα 和 IL-6 与 WOMAC 评分及其子量表（疼痛、僵硬和身体功能）之间的相关性存在差异。TNFα 与总分及其 3 个子量表呈显著正相关，而 IL-6 仅与僵硬子量表呈中度显著负相关。
本研究表明，促炎细胞因子的浓度与膝骨关节炎患者的 KL 分级和 WOMAC 评分相关。虽然 TNFα 与放射学分级无显著相关性，但与 WOMAC 评分显著相关。IL-6 与 KL 分级呈显著负相关，而与僵硬子量表仅呈弱显著相关。结果表明，这些细胞因子以不同的方式在膝关节炎性滑膜炎的发病机制中发挥作用：TNFα 与疼痛相关，而 IL-6 与关节功能相关。
