Institute of Surgical Research, University of Szeged, Szeged, Hungary.
J Surg Res. 2012 Nov;178(1):216-22. doi: 10.1016/j.jss.2012.03.001. Epub 2012 Mar 22.
Joints are privileged compartments that enjoy increased protection against the inflammatory reactions affecting the extremities. We hypothesized that the functional characteristics of the microvasculature would contribute to the differential defensive potential of the synovial membrane.
We investigated the synovial microcirculatory reactions and compared them with those of the tibial periosteum in response to 60 min of total limb ischemia, followed by 180 min of ischemia-reperfusion (IR) in rats. Carrageenan/kaolin-induced knee monoarthritis, a neutrophil-driven synovial inflammation model, served as the positive control.
IR brought about a significant reduction in red blood cell velocity in the capillaries and increases in rolling and adherence of the neutrophil leukocytes in the postcapillary venules (intravital microscopy), in adhesion molecule expression (intercellular adhesion molecule-1 immunohistochemistry) and in xanthine oxidoreductase activity in the periosteum. These changes were also pronounced in carrageenan/kaolin-induced monoarthritis but were almost completely absent in the synovium after the IR challenge. Most importantly, even after IR and in carrageenan/kaolin monoarthritis, the synovial microcirculation was characterized by significantly greater red blood cell velocities than that in the periosteum under resting conditions.
The ischemic duration, which significantly affected the functional integrity of the periosteal microcirculation, did not bring about a marked deterioration in that of the synovial membrane, suggesting that the synovial microcirculation is less endangered to the consequences of short-term tourniquet exposure than the periosteum. The greater microcirculatory red blood cell velocities and lower IR-induced endothelial expression of intercellular adhesion molecule-1 in the synovial membrane might explain the greater resistance of this compartment to the inflammatory consequences of IR.
关节是享有对影响四肢的炎症反应的增加保护的特权隔室。我们假设微血管的功能特性将有助于滑膜的差异防御潜力。
我们研究了滑膜微循环反应，并将其与胫骨骨膜的反应进行了比较，以响应 60 分钟的肢体完全缺血，随后在大鼠中进行 180 分钟的缺血再灌注（IR）。角叉菜胶/高岭土诱导的膝关节单关节炎，一种中性粒细胞驱动的滑膜炎症模型，作为阳性对照。
IR 导致毛细血管中的红细胞速度显著降低，并且在后微静脉中的中性粒细胞白细胞滚动和粘附增加（活体显微镜检查），细胞间粘附分子-1 免疫组织化学）和骨膜中的黄嘌呤氧化还原酶活性。这些变化在角叉菜胶/高岭土诱导的单关节炎中也很明显，但在 IR 挑战后滑膜中几乎完全不存在。最重要的是，即使在 IR 和角叉菜胶/高岭土单关节炎后，滑膜微循环的红细胞速度也明显大于休息状态下的骨膜。
缺血时间显著影响骨膜微循环的功能完整性，但对滑膜膜的功能完整性没有明显恶化，这表明滑膜微循环对短期止血带暴露的后果的威胁较小。滑膜中更高的微循环红细胞速度和更低的 IR 诱导的细胞间粘附分子-1 内皮表达可能解释了该隔室对 IR 的炎症后果的更大抵抗力。
