Vangsness C Thomas, Burke Wendy S, Narvy Steven J, MacPhee Robert D, Fedenko Alexander N
Department of Orthopaedic Surgery, Keck School of Medicine,University of Southern California, 1520 San Pablo Street, LosAngeles, CA 90033, USA.
Bull NYU Hosp Jt Dis. 2011;69(2):122-7.
The purpose of this pilot study was to evaluate the cytokine profile of human knee synovial fluid and correlate this with the subject's degree of articular cartilage degradation, radiographic score, and synovial histology.
Synovial fluid was withdrawn before knee meniscectomy in 12 subjects with varying degrees of osteoarthritis and assayed for 21 cytokines, using a multiplex cytokine assay and flow cytometry instrumentation. Articular cartilage surfaces were scored by a single orthopaedic surgeon on the basis of the International Cartilage Repair Society (ICRS) classification during the arthroscopy, and posterior-anterior knee radiographs were graded using the Kellgren-Lawrence (KL) classification. Synovial biopsies were taken in four zones at the time of surgery for histological analysis.
Significant concentration differences in IL-2, IL-5, MCP-1, and MIP-1 were found between subjects with advanced arthritis and subjects with little or no arthritis on the ICRS scale (p < .05). No such differences could be appreciated using KL scores. There was no correlation between histology samples and visualized surface osteoarthritis.
This data suggests a molecular basis of disease progression, with higher levels of cytokines indicative of greater degrees of osteoarthritis. These results add pilot data that can assist investigators in conducting a comparative observational study of the levels of inflammatory cytokines with radiologic and arthroscopic assessments of osteoarthritis.
本初步研究的目的是评估人膝关节滑液中的细胞因子谱,并将其与受试者的关节软骨退变程度、放射学评分和滑膜组织学进行关联。
在12例不同程度骨关节炎患者行膝关节半月板切除术之前抽取滑液,使用多重细胞因子检测法和流式细胞仪检测21种细胞因子。在关节镜检查期间,由一名骨科医生根据国际软骨修复协会(ICRS)分类对关节软骨表面进行评分,并使用凯尔格伦 - 劳伦斯(KL)分类对膝关节前后位X线片进行分级。手术时在四个区域取滑膜活检组织进行组织学分析。
在ICRS量表上,晚期关节炎患者与几乎没有关节炎或无关节炎患者之间,IL - 2、IL - 5、MCP - 1和MIP - 1存在显著浓度差异(p < .05)。使用KL评分未发现此类差异。组织学样本与可视化的表面骨关节炎之间无相关性。
这些数据提示了疾病进展的分子基础,细胞因子水平越高表明骨关节炎程度越严重。这些结果提供了初步数据,可协助研究人员对骨关节炎的炎症细胞因子水平与放射学和关节镜评估进行比较观察研究。