Rheumatology & Clinical Immunology, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Osteoarthritis Cartilage. 2012 Mar;20(3):233-40. doi: 10.1016/j.joca.2011.12.007. Epub 2011 Dec 21.
Age is the most prominent predisposition for development of osteoarthritis (OA). Age-related changes of articular cartilage are likely to play a role. Advanced glycation endproducts (AGEs) accumulate in cartilage matrix with increasing age and adversely affect the biomechanical properties of the cartilage matrix and influence chondrocyte activity. In clinical studies AGEing of cartilage and its relation to actual cartilage damage can only be measured by surrogate markers (e.g., serum, skin or urine AGE levels and imaging or biochemical markers of cartilage damage). In this study actual cartilage AGE levels were directly related to actual cartilage damage by use of cartilage obtained at joint replacement surgery.
Cartilage and urine samples were obtained from 69 patients undergoing total knee replacement. Samples were analyzed for pentosidine as marker of AGE. Cartilage damage was evaluated macroscopically, histologically, and biochemically.
Cartilage and urine pentosidine both increased with increasing age. The higher the macroscopic, histological, and biochemical cartilage damage the lower the cartilage pentosidine levels were. In multiple regression analysis age is not found to be a confounder.
There is an inverse relation between cartilage AGEs and actual cartilage damage in end-stage OA. This is likely due to ongoing (ineffective) increased turnover of cartilage matrix proteins even in end stage disease.
年龄是骨关节炎(OA)发展的最突出倾向。关节软骨的年龄相关性变化可能起作用。随着年龄的增长,高级糖基化终产物(AGEs)在软骨基质中积累,并对软骨基质的生物力学特性产生不利影响,影响软骨细胞活性。在临床研究中,只能通过替代标志物(例如血清、皮肤或尿液中的 AGE 水平以及软骨损伤的影像学或生化标志物)来测量软骨的老化及其与实际软骨损伤的关系。在这项研究中,通过使用关节置换手术中获得的软骨,直接将实际软骨中的 AGE 水平与实际软骨损伤相关联。
从 69 名接受全膝关节置换术的患者中获取软骨和尿液样本。使用戊糖作为 AGE 的标志物来分析样本。通过宏观、组织学和生化评估软骨损伤。
软骨和尿液中的戊糖都随着年龄的增长而增加。宏观、组织学和生化评估的软骨损伤越高,软骨戊糖水平越低。在多元回归分析中,年龄不是混杂因素。
在终末期 OA 中,软骨 AGE 与实际软骨损伤之间存在反比关系。这可能是由于即使在终末期疾病中,软骨基质蛋白的持续(无效)高周转率所致。