Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK; Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield Road, Sutton in Ashfield NG17 4JL, UK.
Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK.
Osteoarthritis Cartilage. 2012 May;20(5):405-412. doi: 10.1016/j.joca.2012.01.012. Epub 2012 Jan 25.
The distribution and function of lymphatic vessels in normal and diseased human knees are understood incompletely. This study aimed to investigate whether lymphatic density is associated with clinical, histological or radiographic parameters in osteoarthritis (OA).
Sections of synovium from 60 knees from patients with OA were compared with 60 post mortem control knees (from 37 individuals). Lymphatic vessels were identified using immunohistochemistry for podoplanin, and quantified as lymphatic vessel density (LVD) and lymphatic endothelial cell (LEC) fractional area. Effusion status was determined by clinical examination, radiographs were scored for OA changes, and inflammation grading used haematoxylin and eosin stained sections of synovium.
Lymphatic vessels were present in synovia from both disease groups, but were not identified in subchondral bone. Synovial lymphatic densities were independent of radiological severity and age. Synovia from patients with OA displayed lower LVD (z=-3.4, P=0.001) and lower LEC fractional areas (z=-4.5, P<0.0005) than non-arthritic controls. In patients with OA, low LVD was associated with clinically detectable effusion (z=-2.2, P=0.027), but not with histological evidence of synovitis. The negative associations between lymphatics and OA/effusion appeared to be independent of other measured confounders.
Lymphatic vessels are present in lower densities in OA synovia. Abnormalities of synovial fluid drainage may confound the value of effusion as a clinical sign of synovitis in OA.
人体膝关节正常和患病组织中的淋巴管分布和功能尚未完全明确。本研究旨在探讨在骨关节炎（OA）中，淋巴管密度是否与临床、组织学或影像学参数相关。
对 60 例 OA 膝关节滑膜组织切片与 60 例尸检对照膝关节（来自 37 人）进行比较。使用 podoplanin 免疫组化方法鉴定淋巴管，并对淋巴管密度（LVD）和淋巴管内皮细胞（LEC）面积分数进行量化。通过临床检查确定关节积液情况，对 X 线片进行 OA 改变评分，并使用苏木精和伊红染色的滑膜切片进行炎症分级。
在两组疾病滑膜中均存在淋巴管，但在下骨中未发现。滑膜淋巴管密度与放射学严重程度和年龄无关。OA 患者的滑膜 LVD（z=-3.4，P=0.001）和 LEC 面积分数（z=-4.5，P<0.0005）均低于非关节炎对照组。在 OA 患者中，低 LVD 与临床上可检测到的关节积液相关（z=-2.2，P=0.027），但与滑膜炎症的组织学证据无关。淋巴管与 OA/关节积液之间的负相关关系似乎独立于其他测量的混杂因素。
OA 滑膜中的淋巴管密度较低。滑膜液引流异常可能会影响关节积液作为 OA 滑膜炎症的临床标志的价值。
