Department of Orthopedic Surgery, Xin‑Hua Hospital, Shanghai Jiao‑Tong University School of Medicine, Shanghai 200092, P.R. China.
Mol Med Rep. 2019 Apr;19(4):2808-2816. doi: 10.3892/mmr.2019.9910. Epub 2019 Jan 30.
Developmental dysplasia of the hip (DDH) is a common musculoskeletal disorder characterized by progressive joint soreness and limited mobility. The aim of the present study was to investigate the pathological changes and inflammatory infiltration in the hypertrophic synovium of the hip joint associated with the progression of DDH. Synovial biopsies in the hip joint are obtained from patients with moderate DDH and severe DDH during surgery. These biopsies are processed for histological and immunohistochemical (IHC) analysis and investigation of the pathological processes in a synovium, including types of inflammatory cell infiltration, synovial angiogenesis and fibrosis, neuron endings and neuropeptide invasion. Correlation analysis was performed between the mean optical density (MOD) of each antibody, and Harris hip score (HHS) and visual analogue score (VAS) using the Spearman correlation test. Chronic inflammation in the synovium was observed via the positive IHC staining of inflammatory cells, such as T cells, B cells, macrophages and leukocytes. Excessive staining of vimentin and α smooth muscle actin in the synovium of severe DDH represented significant fibrosis and angiogenesis. These targets were also significantly correlated with HHS in severe DDH. The MOD levels of CD68 (indicators of macrophage) indicated apparent correlations with HHS and VAS in patients with severe DDH. The labels of nerve fibers and pain transmission indicators were as follows: Neurofilament‑200 and substance P. Calcitonin gene‑related peptide was upregulated in the synovium of severe DDH in contrast to that in the synovium of moderate DDH. The MOD levels of NF‑200, SP and CGRP were correlated with VAS in severe DDH. The pathology of DDH includes chronic inflammatory cell infiltration corresponding with nerve fibers and fibroblastic proliferation, which might contribute to arthritis progression and joint soreness in DDH.
髋关节发育不良（DDH）是一种常见的肌肉骨骼疾病，其特征为关节疼痛进行性加重和活动度受限。本研究旨在探讨与 DDH 进展相关的髋关节肥厚滑膜的病理变化和炎症浸润。在手术过程中，从患有中度和重度 DDH 的患者髋关节中获取滑膜活检。对这些活检进行组织学和免疫组织化学（IHC）分析，以研究滑膜的病理过程，包括炎症细胞浸润、滑膜血管生成和纤维化、神经元末梢和神经肽浸润的类型。采用 Spearman 相关检验对每个抗体的平均光密度（MOD）与 Harris 髋关节评分（HHS）和视觉模拟评分（VAS）之间进行相关性分析。通过对 T 细胞、B 细胞、巨噬细胞和白细胞等炎症细胞的 IHC 染色阳性，观察到滑膜中的慢性炎症。重度 DDH 滑膜中波形蛋白和α平滑肌肌动蛋白的过度染色代表明显的纤维化和血管生成。这些靶标与重度 DDH 中的 HHS 也具有显著相关性。CD68（巨噬细胞标志物）的 MOD 水平与重度 DDH 患者的 HHS 和 VAS 呈明显相关。神经纤维和疼痛传递标志物的标签如下：神经丝蛋白-200 和 P 物质。与中度 DDH 滑膜相比，重度 DDH 滑膜中降钙素基因相关肽上调。NF-200、SP 和 CGRP 的 MOD 水平与重度 DDH 中的 VAS 相关。DDH 的病理学包括与神经纤维和成纤维细胞增殖对应的慢性炎症细胞浸润，这可能导致 DDH 关节炎进展和关节疼痛。
