Yıldızgören Mustafa Turgut, Karataş Toğral Arzu, Baki Ali Erdem, Ekiz Timur
Department of Physical Medicine and Rehabilitation, Ankara Occupational Diseases Hospital, Ankara, Turkey,
Clin Rheumatol. 2015 Jul;34(7):1255-8. doi: 10.1007/s10067-014-2733-9. Epub 2014 Jul 2.
Effects of retinoic acid on collagen synthesis and cartilage have previously been shown. However, its effects on cartilage and tendons in humans have not been studied yet. Therefore, in order to provide a morphologic insight, the aim of this study was to measure femoral cartilage, Achilles and supraspinatus tendon thicknesses in patients under systemic isotretinoin treatment by using ultrasound. Fifteen patients (nine F, six M) who used isotretinoin for their acnes were included. All patients were treated with isotretinoin 0.5 mg/kg/day for the first month, and the dosage was escalated up to 1 mg/kg/day thereafter. Distal femoral cartilage, supraspinatus, and Achilles tendons thicknesses have been evaluated both before the treatment and at the end of the third month. Femoral cartilage thicknesses were assessed from three midpoints bilaterally; medial condyle, lateral condyle, and intercondylar area. Short/long-axis diameters and cross-sectional area of the Achilles tendons and axial tendon thicknesses of supraspinatus tendon were evaluated from the nondominant side. The mean age of the patients was 20.1 ± 4.9 years, and body mass index was 21.7 ± 2.5 kg/m(2). Although posttreatment cartilage measurements of 30 knees were lower for the three midpoints, it reached significance only for lateral condyle (p = 0.05). In addition, posttreatment tendon measurements were not statistically significant compared with pretreatment values (all p > 0.05). Systemic isotretinoin treatment seems to make cartilage thinner. Further studies considering histological and molecular evaluations with more sample sizes are awaited.
维甲酸对胶原蛋白合成和软骨的影响此前已有报道。然而，其对人体软骨和肌腱的影响尚未得到研究。因此，为了提供形态学方面的见解，本研究的目的是通过超声测量全身使用异维甲酸治疗的患者的股骨软骨、跟腱和冈上肌腱厚度。纳入了15名因痤疮使用异维甲酸的患者（9名女性，6名男性）。所有患者在第一个月接受0.5mg/kg/天的异维甲酸治疗，此后剂量逐渐增加至1mg/kg/天。在治疗前和第三个月末评估股骨远端软骨、冈上肌和跟腱的厚度。双侧从三个中点评估股骨软骨厚度；内侧髁、外侧髁和髁间区域。从非优势侧评估跟腱的短/长轴直径和横截面积以及冈上肌腱的轴向肌腱厚度。患者的平均年龄为20.1±4.9岁，体重指数为21.7±2.5kg/m²。虽然30个膝关节的治疗后软骨测量值在三个中点处较低，但仅外侧髁达到显著水平（p=0.05）。此外，与治疗前值相比，治疗后肌腱测量值无统计学意义（所有p>0.05）。全身使用异维甲酸治疗似乎会使软骨变薄。期待进一步开展样本量更大的组织学和分子评估研究。
