Department of Orthopaedic Surgery, Yokohama City University School of Medicine , 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004 , Japan.
Mod Rheumatol. 2003 Dec;13(4):301-4. doi: 10.3109/s10165-003-0253-6.
Abstract The synovium in a knee joint has an extensive neural network in the somatic and autonomic nervous systems. In medial compartmental osteoarthritis of the knee, neuropeptides were most abundant, with an especially large number of substance P and calcitonin gene-related peptide-immunoreactive free nerve endings. Some of the substance P-positive nerve endings were surrounded by monocytes. Substance P and calcitonin gene-related peptide were found more frequently in the medial than in the lateral or suprapatellar areas. Substance P-positive free nerve endings showed more dendritic morphologic features in the medial region than those in the lateral and suprapatellar regions, and small nerves were accompanied by newly developed vessels in synovial villi. In the medial region, the synovitis was more remarkable than in the lateral region. Patients suffering from medial compartmental osteoarthritis of the knee complain of pain on the anteromedial portion of the knee joint when walking or standing. Therefore, these findings suggest that free nerve endings containing substance P may be implicated in the development and persistence of inflammatory synovitis and the pain pathway in osteoarthritis of the knee.
摘要 膝关节滑膜内存在广泛的躯体和自主神经系统神经网络。在膝关节内侧间室骨关节炎中，神经肽最为丰富，尤其有大量的 P 物质和降钙素基因相关肽免疫反应性游离神经末梢。一些 P 物质阳性神经末梢被单核细胞包围。与外侧或髌上区域相比，内侧区域更常发现 P 物质和降钙素基因相关肽。内侧区域的 P 物质阳性游离神经末梢表现出比外侧和髌上区域更多的树突形态特征，并且在滑膜绒毛中有伴随新发育的小血管的小神经。在内侧区域，滑膜炎比外侧区域更明显。患有膝关节内侧间室骨关节炎的患者在行走或站立时会感到膝关节前内侧疼痛。因此，这些发现表明，含有 P 物质的游离神经末梢可能与炎症性滑膜炎的发展和持续以及膝关节骨关节炎的疼痛途径有关。
