Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, USA.
Department of Veterinary Pathobiology, Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
Vet Surg. 2021 Jul;50(5):1032-1041. doi: 10.1111/vsu.13600. Epub 2021 Mar 26.
To investigate histopathological features of synovium from dogs with cranial cruciate ligament disease (CCLD) to seek mechanisms of osteoarthritis (OA) associated with CCLD.
Retrospective, single-institution case series.
Thirty client-owned dogs.
Synovial biopsies (n = 30) obtained from stifles with CCLD were assessed by using two synovitis histopathology grading systems (Krenn and Hospital for Special Surgery [HSS]). The Krenn synovitis score was interpreted as "no synovitis," "low-grade," or "high-grade," while inflammatory subtype (low, mixed, or high) was determined by a computational algorithm within the HSS system. Comparison of synovitis scores was based on degree of CCL rupture and presence of meniscal tears.
Histopathological changes and synovitis scores were similar regardless of degree of rupture (partial n = 5, complete n = 25) or presence of meniscal injury (n = 12) and were characterized by hyperplastic and lymphoplasmacytic synovitis with increased vascularity (30/30) and the presence of hemosiderin deposits (28/30), binucleated plasma cells (28/30), mucoid change (25/30), and Mott cells (16/30). Thirteen (43%) specimens were consistent with high-grade synovitis according to the Krenn system, while 11 (37%) specimens fit into the high-inflammatory subtype with the HSS system.
Synovitis associated with canine CCLD in this study population was lymphoplasmacytic and was often highly inflammatory, with the presence of cells pertaining to humoral immunity. Humoral immune responses may play key roles in the synovitis associated with CCLD.
Modulation of biological factors that provoke humoral immune responses may mitigate symptoms of OA that persist and progress even after surgical treatment of CCLD in dogs.
研究患有十字韧带断裂(CCLD)的犬的滑膜组织的组织病理学特征,以寻求与 CCLD 相关的骨关节炎(OA)的发病机制。
回顾性、单机构病例系列研究。
30 只患犬。
对 30 只患有 CCLD 的犬的膝关节滑膜活检组织进行评估,使用两种滑膜炎组织病理学分级系统(Krenn 和特种外科医院[HSS])。Krenn 滑膜炎评分解释为“无滑膜炎”、“低级别”或“高级别”,而炎症亚型(低、混合或高)则由 HSS 系统中的计算算法确定。滑膜炎评分的比较基于 CCL 断裂的程度和半月板损伤的存在。
无论 CCL 断裂程度(部分断裂 n=5,完全断裂 n=25)或半月板损伤存在与否(n=12),滑膜组织的组织病理学变化和滑膜炎评分均相似,其特征为增生性和淋巴浆细胞性滑膜炎,伴有血管增多(30/30)和含铁血黄素沉积(28/30)、双核浆细胞(28/30)、黏液样变(25/30)和粘蛋白细胞(16/30)。根据 Krenn 系统,13 份(43%)标本符合高级别滑膜炎,而根据 HSS 系统,11 份(37%)标本符合高炎症亚型。
本研究人群中与犬 CCLD 相关的滑膜炎为淋巴浆细胞性,且通常为高度炎症性,存在与体液免疫有关的细胞。体液免疫反应可能在与 CCLD 相关的滑膜炎中发挥关键作用。
调节引发体液免疫反应的生物因素可能会减轻即使在犬 CCLD 手术后仍持续存在和进展的 OA 症状。