Punzi L, Schiavon F, Cavasin F, Ramonda R, Gambari P F, Todesco S
Cattedra e Divisione di Reumatologia, Università di Padova, Italy.
Clin Exp Rheumatol. 1989 May-Jun;7(3):247-50.
Prostaglandin (PG)E2, cyclic adenosine monophosphate (cAMP), white blood cells (WBC), total protein (TP), total complement activity (CH50) and beta-2-microglobulin (beta-2-m) were measured at baseline and after eight days in the synovial fluid (SF) of 16 patients affected with knee-joint effusion due to various arthropathies. The volume of SF was also calculated. Eight patients--4 with rheumatoid arthritis (RA), 2 with recurrent monoarthritis (RM) and 2 with osteoarthritis (OA) were randomly allocated to the treatment with intra-articular injection of Hyalgan (HA, Na-hyaluronate, 20 mg/2 ml), while eight patients having similar arthropathies--4 RA, 2 RM and 2 OA--were not treated (control group). In the patients treated with HA a significant reduction of SF volume (from 28.5 +/- 5.1 ml to 20.5 +/- 4.0 ml; p less than 0.02) and PGE2 (from 96.1 +/- 22.7 pg/ml to 66.2 +/- 14.5 pg/ml; p less than 0.05) was found, whereas cAMP concentration was significantly increased (from 4.5 +/- 0.7 pmol/ml to 7.2 +/- 1.2 pmol/ml; p less than 0.05). No significant variations were observed in the control group. Moreover, no differences in WBC count, TP and beta-2-m and CH50 were found in either group. These data could suggest an anti-inflammatory effect of HA that appears to be mediated by PG-inhibition as well as cAMP stimulation.
在16例因各种关节病导致膝关节积液的患者的滑液（SF）中，于基线及8天后测定了前列腺素（PG）E2、环磷酸腺苷（cAMP）、白细胞（WBC）、总蛋白（TP）、总补体活性（CH50）和β2-微球蛋白（β2-m）。还计算了滑液的体积。8例患者——4例类风湿关节炎（RA）、2例复发性单关节炎（RM）和2例骨关节炎（OA）——被随机分配接受关节腔内注射透明质酸钠（HA，20mg/2ml）治疗，而另外8例患有类似关节病的患者——4例RA、2例RM和2例OA——未接受治疗（对照组）。在接受HA治疗的患者中，发现滑液体积显著减少（从28.5±5.1ml降至20.5±4.0ml；p<0.02），PGE2也显著降低（从96.1±22.7pg/ml降至66.2±14.5pg/ml；p<0.05），而cAMP浓度显著升高（从4.5±0.7pmol/ml升至7.2±1.2pmol/ml；p<0.05）。对照组未观察到显著变化。此外，两组在WBC计数、TP、β2-m和CH50方面均未发现差异。这些数据表明HA具有抗炎作用，其作用似乎是通过抑制PG以及刺激cAMP介导的。
