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玻璃酸钠化学关节内注射治疗骨关节炎的研究进展

The impact of chemical synovectomy with sodium morrhuate on human chondrocytes and cartilage in vitro.

机构信息

Department of Orthopaedic Surgery, University of Regensburg, Bad Abbach, Germany.

出版信息

Rheumatol Int. 2013 May;33(5):1201-6. doi: 10.1007/s00296-012-2518-x. Epub 2012 Sep 15.

Abstract

The vessel sclerosing property of sodium morrhuate is useful in treatment of recurrent joint effusions particularly in cases of knee joint effusions. It also can be employed as an addition to surgical synovectomy. Little is known about the effects of this drug on cartilage. This study was designed to investigate the cytotoxic impact of sodium morrhuate on human chondrocytes and cartilage tissue in vitro. Primary chondrocytes from 13 patients were isolated and cultivated in three-dimensional alginate cultures. Furthermore, femoral cartilage explants of 10 patients were cultivated in vitro. Both chondrocytes and cartilage explants were exposed to mixture of sodium morrhuate and mepivacaine in different concentrations simulating chemical synovectomy. After 48 h, cell proliferation, viability, and cytotoxicity were measured. The cartilage specimens were analyzed for apoptosis by immunohistochemistry. Up to a dilution of 1:600, cells were found to be 100 % viable with a proliferation rate of 74 % compared to controls. From 1:400 onwards, a significant increase in LDH release was measured which reached at dilution of 1:200 74 % of high control, whereas histological examination showed no proof of apoptosis or necrosis in cartilage tissue. The results of this in vitro study demonstrate that the cytotoxic effects of sodium morrhuate on human chondrocytes, which lack their original extracellular matrix, manifest between dilutions of 1:500 and 1:400 and increase with higher concentrations of the drug. This effect was not found for cartilage explants, though.

摘要

鱼精蛋白的血管硬化特性在治疗复发性关节积液,特别是膝关节积液方面非常有用。它也可以作为滑膜切除术的辅助手段。关于这种药物对软骨的影响知之甚少。本研究旨在探讨鱼精蛋白对体外培养的人软骨细胞和软骨组织的细胞毒性作用。从 13 名患者中分离出原代软骨细胞,并在三维藻酸盐培养物中培养。此外,还对 10 名患者的股骨软骨标本进行了体外培养。软骨细胞和软骨标本均暴露于模拟化学滑膜切除术的鱼精蛋白和甲哌卡因混合物中,不同浓度下。48 小时后,测量细胞增殖、活力和细胞毒性。通过免疫组织化学分析软骨标本中的细胞凋亡。在 1:600 的稀释度下,细胞的存活率为 100%,与对照组相比,增殖率为 74%。从 1:400 开始,测量到 LDH 释放显著增加,在 1:200 的稀释度下达到高对照组的 74%,而组织学检查显示软骨组织中没有细胞凋亡或坏死的证据。这项体外研究的结果表明,鱼精蛋白对原代软骨细胞的细胞毒性作用在 1:500 至 1:400 的稀释度之间表现出来,并且随着药物浓度的增加而增加。然而,这种作用在软骨标本中并未发现。

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