Williams J M, Brandt K D
Arthritis Rheum. 1985 Nov;28(11):1267-74. doi: 10.1002/art.1780281111.
Although corticosteroids have been shown to cause articular cartilage degeneration, recent studies of experimentally induced osteoarthritis indicate that under certain conditions they may protect against cartilage damage and osteophyte formation. The present study examines the in vivo effect of triamcinolone hexacetonide on the degeneration of articular cartilage which occurs following intraarticular injection of sodium iodoacetate. Three weeks after a single injection of iodoacetate into the knees of guinea pigs, ipsilateral femoral condylar cartilage exhibited fibrillation, loss of staining with Safranin O, depletion of chondrocytes, and prominent osteophytes. In striking contrast, when triamcinolone hexacetonide was injected into the ipsilateral knee 24 hours after the intraarticular injection of iodoacetate, fibrillation was noted in only 1 of 6 samples, osteophytes were much less prominent, pericellular staining with Safranin O persisted, and cell loss was less extensive. Knees of animals which received only one-tenth as much intraarticular triamcinolone hexacetonide after the iodoacetate injection also exhibited marked reduction in size and extent of osteophytes. However, the degree of fibrillation, loss of Safranin O staining, and chondrocyte depletion was similar to that observed in animals injected with iodoacetate but not treated with intraarticular steroid. No apparent morphologic or histochemical changes were observed after intraarticular injection of the steroid preparation alone. Thus, triamcinolone hexacetonide produced a marked, dose-dependent protective effect in this model of chemically induced articular cartilage damage.
尽管皮质类固醇已被证明会导致关节软骨退变,但最近对实验性诱导骨关节炎的研究表明,在某些条件下它们可能预防软骨损伤和骨赘形成。本研究检测了曲安奈德己酸酯对关节内注射碘乙酸钠后发生的关节软骨退变的体内效应。向豚鼠膝关节单次注射碘乙酸钠三周后,同侧股骨髁软骨出现原纤维形成、番红O染色缺失、软骨细胞减少以及明显的骨赘。与之形成显著对比的是,在关节内注射碘乙酸钠24小时后向同侧膝关节注射曲安奈德己酸酯,6个样本中只有1个出现原纤维形成,骨赘不那么明显,番红O的细胞周染色持续存在,细胞丢失也不那么广泛。在注射碘乙酸钠后仅接受十分之一剂量关节内曲安奈德己酸酯的动物膝关节,骨赘的大小和范围也显著减小。然而,原纤维形成程度、番红O染色缺失以及软骨细胞减少程度与注射碘乙酸钠但未接受关节内类固醇治疗的动物相似。单独关节内注射类固醇制剂后未观察到明显的形态学或组织化学变化。因此,在这个化学诱导的关节软骨损伤模型中,曲安奈德己酸酯产生了显著的、剂量依赖性的保护作用。