Iwasaki A, Inoue K, Hukuda S
Department of Orthopaedic Surgery, Shiga University of Medical Science, Japan.
Clin Exp Rheumatol. 1995 Mar-Apr;13(2):173-8.
The innervation of normal rat synovium and adjacent bone, especially the communicatory nerve fibers between them, were investigated.
Nerve fibers were visualized using immunohistochemistry. Antisera to substance P(SP) and antisera to calcitonin gene-related peptide (CGRP) were employed to identify sensory nerves, while antisera to neuropeptide Y (NPY) were used to identify sympathetic nerves.
In the synovium, SP-positive nerve fibers were found in the lining cell layer, with some fibers branching toward the joint space. In the sublining layer of the synovium, SP-positive and CGRP-positive fibers were observed mainly near the blood vessels. NPY-positive fibers were predominantly seen as a network around the blood vessels in the sublining layer. A large number of SP-positive and CGRP-positive fibers were seen near the attachment of the meniscus to the synovium. Toluidine blue positive mast cells were detected in close proximity to all three types of fibers, especially near the blood vessels. In bones forming the knee joint, nerve fibers immunoreactive to SP, CGRP and NPY were present in the bone marrow and some of these fibers communicated with the synovium through the synovium-bone junction located in the bare area.
The role of nerves, especially the role of the communicatory nerves between the synovium and the bone marrow, should be considered in the pathophysiolosy of erosive arthritis.
研究正常大鼠滑膜及其相邻骨组织的神经支配情况,特别是它们之间的联络神经纤维。
采用免疫组织化学方法显示神经纤维。用P物质(SP)抗血清和降钙素基因相关肽(CGRP)抗血清识别感觉神经,用神经肽Y(NPY)抗血清识别交感神经。
在滑膜的衬里细胞层发现SP阳性神经纤维,一些纤维向关节腔分支。在滑膜的衬里下层,SP阳性和CGRP阳性纤维主要见于血管附近。NPY阳性纤维主要表现为衬里下层血管周围的网络。在半月板与滑膜连接处附近可见大量SP阳性和CGRP阳性纤维。在所有三种类型的纤维附近,尤其是血管附近,检测到甲苯胺蓝阳性肥大细胞。在构成膝关节的骨组织中,骨髓中存在对SP、CGRP和NPY免疫反应的神经纤维,其中一些纤维通过位于裸露区的滑膜-骨连接处与滑膜相通。
在侵蚀性关节炎的病理生理学中,应考虑神经的作用,尤其是滑膜与骨髓之间联络神经的作用。