Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
J Orthop Res. 2013 Jan;31(1):44-52. doi: 10.1002/jor.22182. Epub 2012 Jul 9.
To date, there is no objective or reliable means of assessing the severity of degenerative joint disease (DJD) and need for joint replacement surgery. Hence, it is difficult to know when an individual with DJD has reached a point where total arthroplasty is indicated. The purpose of the present study is to determine whether serum levels of Alpha-2 HS-glycoprotein (AHSG) as well as bone morphogenetic proteins (BMP-2, 4, 7) can be used to predict the presence of severe DJD of the hip and/or temporomandibular joint (TMJ) (specifically: joints that require replacement). A total of 30 patients scheduled for arthroplasty (diseased) (15 HIP, 15 TMJ) and 120 age-matched controls (healthy/non-diseased) were included. Blood samples were collected from all patients ≥8 weeks after the last arthroplasty. Concentrations of serum analytes were measured using enzyme-linked immunosorbent assays, and these were compared between the Diseased and Healthy groups, utilizing the Mann-Whitney U-test. Patients with disease had significantly higher levels of BMP-2 and BMP-4 and lower levels of AHSG in serum compared to non-diseased humans (p < 0.01). Higher levels of BMP-2, 4 and reduced levels of AHSG appear to characterize patients who have DJD that is severe enough to require total joint replacement. Perhaps measurements of these proteins can be used to make objective decisions regarding the need for total arthroplasty as opposed to the current subjective approaches.
迄今为止,尚无客观可靠的方法来评估退行性关节疾病(DJD)的严重程度和是否需要进行关节置换手术。因此,很难知道 DJD 患者何时达到需要全关节置换的程度。本研究的目的是确定血清α-2HS-糖蛋白(AHSG)水平以及骨形态发生蛋白(BMP-2、4、7)是否可用于预测髋关节和/或颞下颌关节(TMJ)的严重 DJD(具体为:需要置换的关节)。共纳入 30 名计划行关节置换术(患病)(15 名髋关节,15 名 TMJ)和 120 名年龄匹配的对照者(健康/无疾病)。所有患者在最后一次关节置换术后≥8 周采集血样。使用酶联免疫吸附测定法测量血清分析物的浓度,并利用曼-惠特尼 U 检验比较患病组和健康组之间的浓度。与健康人相比,患病患者的血清中 BMP-2 和 BMP-4 水平明显升高,AHSG 水平明显降低(p<0.01)。BMP-2、4 水平升高和 AHSG 水平降低似乎是 DJD 严重到需要全关节置换的患者的特征。也许这些蛋白质的测量可以用于做出关于是否需要全关节置换的客观决策,而不是当前的主观方法。