Orthopedic Department, San Gerardo Hospital, 20900 Monza, Italy.
J Orthop Res. 2013 Feb;31(2):315-21. doi: 10.1002/jor.22208. Epub 2012 Aug 6.
Surgical reconstruction of the anterior cruciate ligament (ACL) does not necessarily decrease the risk of developing osteoarthritis (OA). The inflammatory response and relative changes in pro- and anti-inflammatory cytokines could participate in triggering the development of OA. To test this hypothesis we measured the concentrations of IL-1β, IL-1ra, IL-6, IL-8, IL-10, and TNF-α at different times after ACL rupture. The sample population consisted of 48 patients with ACL tear which were assigned to different groups according to the time elapsed from the injury: 22 acute (A), 7 early sub-acute (ESA), 11 late sub-acute (LSA), and 8 chronic (C). In group A, there were high levels of IL-1β, IL-6, and IL-8, whereas levels of IL-1ra and TNF-α were significantly lower than usually reported. IL-1β and IL-8 concentrations returned with time to normal levels in the ESA group. Interestingly, IL-1ra levels remained always significantly lower than normally reported levels, and TNF-α levels did not increase after trauma. Our data show increased level of pro-inflammatory cytokines (IL-6 and IL-8) in the acute phase of inflammation which could be responsible for triggering cartilage catabolism and suggest that prompt neutralization of IL-6 and IL-8 accumulations in synovial fluid could help prevent development of OA in ACL-injured knees.
前交叉韧带 (ACL) 的手术重建不一定会降低患骨关节炎 (OA) 的风险。炎症反应和促炎与抗炎细胞因子的相对变化可能参与触发 OA 的发展。为了验证这一假设,我们在 ACL 撕裂后不同时间测量了 IL-1β、IL-1ra、IL-6、IL-8、IL-10 和 TNF-α 的浓度。样本人群由 48 名 ACL 撕裂患者组成,根据受伤后时间的不同分为不同组:22 名急性(A)、7 名早期亚急性(ESA)、11 名晚期亚急性(LSA)和 8 名慢性(C)。在 A 组中,IL-1β、IL-6 和 IL-8 水平较高,而 IL-1ra 和 TNF-α 水平明显低于通常报道的水平。在 ESA 组中,IL-1β 和 IL-8 浓度随时间恢复正常水平。有趣的是,IL-1ra 水平始终保持明显低于通常报道的水平,而 TNF-α 水平在创伤后并未增加。我们的数据显示,在炎症的急性期,促炎细胞因子(IL-6 和 IL-8)水平升高,这可能是引发软骨分解代谢的原因,并表明及时中和滑液中 IL-6 和 IL-8 的积聚可能有助于预防 ACL 损伤膝关节 OA 的发展。