UHZ Sports Medicine Institue, Coral Gables, FL, USA.
Foot Ankle Int. 2012 Aug;33(8):627-31. doi: 10.3113/FAI.2012.0627.
Articular cartilage degeneration is mediated by inflammatory cytokines and fragments of structural matrix proteins. Few studies have examined the role of these biomarkers in intra-articular pathology of the ankle.
Four groups of patients with increasing ankle pathology were enrolled. Group 1 included controls with no pain who underwent unrelated forefoot surgery. Group 2 included patients undergoing arthroscopy with intraoperative mild chondrosis. Group 3 included patients undergoing arthroscopy with moderate/severe chondrosis, osteochondral lesions, impingement, or loose bodies. Group 4 included positive controls with severe arthrosis undergoing ankle arthrodesis/arthroplasty. Ankle fluid was obtained by intra-articular aspiration and was assayed for IL-6, IFN-γ, MCP, MIP-1β, and fibronectin-aggrecan complex (FAC), a matrix-degradation marker. There were 36 patients total, 21 males and 15 females with a mean age 45 (±16; range 18 to 76) years and a mean VAS for pain of 4.7 (±3.5; range 0 to 9). In groups 1 through 4, there were 11, 6, 15 and 4 patients respectively.
The mean values of MCP-1 were 49.8 (±8.0) for minimal pathology and 133.9 (±33.0) for substantial pathology (pg/ml). The mean values of the FAC were 2.83 (±1.16) for minimal pathology and 9.62 (±2.23) for substantial pathology (optical density at 450 nm). The groups differed significantly in age, preoperative VAS, FAC, IL-6, and MCP-1 (p<0.05).
There are differences in FAC and MCP-1 with increasing grades of severity of intra-articular pathology.
These tests may play a role in determining the necessity for arthroscopy or intra-articular procedures in equivocal candidates.
关节软骨退变是由炎症细胞因子和结构基质蛋白片段介导的。很少有研究探讨这些生物标志物在踝关节腔内病变中的作用。
纳入了 4 组具有不同踝关节病变程度的患者。第 1 组为无疼痛且接受无关前足手术的对照组。第 2 组为行关节镜检查且术中存在轻度软骨退变的患者。第 3 组为行关节镜检查且存在中度/重度软骨退变、骨软骨损伤、撞击或游离体的患者。第 4 组为行踝关节融合/关节置换术且严重关节炎的阳性对照组。通过关节内抽吸获得踝关节液，并检测白细胞介素 6 (IL-6)、干扰素 γ (IFN-γ)、单核细胞趋化蛋白 1 (MCP-1)、巨噬细胞炎性蛋白 1β (MIP-1β)和纤维连接蛋白-聚集蛋白复合物 (FAC)，一种基质降解标志物。共有 36 例患者，男性 21 例，女性 15 例，平均年龄 45（±16；范围 18 至 76）岁，平均疼痛视觉模拟评分（VAS）为 4.7（±3.5；范围 0 至 9）。在第 1 至 4 组中，分别有 11、6、15 和 4 例患者。
最小病变组的 MCP-1 平均水平为 49.8（±8.0）pg/ml，而严重病变组为 133.9（±33.0）pg/ml。最小病变组的 FAC 平均水平为 2.83（±1.16），而严重病变组为 9.62（±2.23）。各组在年龄、术前 VAS、FAC、IL-6 和 MCP-1 方面存在显著差异（p<0.05）。
随着关节内病变严重程度的增加，FAC 和 MCP-1 存在差异。
这些检测结果可能在确定疑似患者是否需要关节镜或关节内手术方面发挥作用。
