Armstrong S, Read R, Ghosh P
Veterinary School, Murdoch University, Australia.
J Rheumatol. 1994 Apr;21(4):680-8.
Intraarticular (ia) hyaluronan (HA) is reported to provide symptomatic relief in osteoarthritis (OA); however, there is limited information on the effects that this treatment may have on joint articular cartilage or subchondral bone. Our objective was to address this issue using an ovine model of early OA.
Unilateral medial meniscectomy was performed in 10 adult merino sheep, and 5 unoperated animals were used as controls (UOC). Sixteen weeks postmeniscectomy, joints of 5 operated animals were injected with 2 ml of HA (Artz, 10 mg/ml, M(r) = 0.9 x 10(6) Da) ia while the remaining 5 operated animals received 2 ml of sterile saline ia. This protocol was continued for a further 4 weeks. All animals were sacrificed 5 weeks after the last injection; however 3 weeks before sacrifice they were given tetracycline (20 mg/kg intravenously) weekly. Bone slabs, including articular cartilage, were cut from the medial tibial plateaux and femoral condyles, processed for histology, histomorphometry and fluorescence microscopy to assess articular cartilage and subchondral bone pathology.
Meniscectomy and saline treatment increased osteoid volume and surfaces as well as increased the extent of tetracycline labelling of the subchondral bone relative to UOC. The articular cartilage also exhibited a significantly higher modified Mankin's score than UOC. In the HA injected group the aforementioned articular cartilage and subchondral bone changes were modified such that the observed variables were indistinguishable from UOC.
Using this animal model intraarticular HA appeared to limit the development of articular cartilage and subchondral bone changes characteristic of early OA.
据报道,关节内注射透明质酸(HA)可缓解骨关节炎(OA)的症状;然而,关于这种治疗方法对关节软骨或软骨下骨的影响,相关信息有限。我们的目的是使用早期OA的绵羊模型来解决这个问题。
对10只成年美利奴绵羊进行单侧内侧半月板切除术,5只未手术的动物作为对照(UOC)。半月板切除术后16周,给5只手术动物的关节内注射2 ml HA(Artz,10 mg/ml,M(r)=0.9×10(6) Da),其余5只手术动物关节内注射2 ml无菌生理盐水。该方案持续4周。最后一次注射后5周处死所有动物;然而,在处死前3周,每周给它们静脉注射四环素(20 mg/kg)。从内侧胫骨平台和股骨髁切取包括关节软骨的骨块,进行组织学、组织形态计量学和荧光显微镜检查,以评估关节软骨和软骨下骨的病理情况。
与UOC相比,半月板切除术和生理盐水治疗增加了类骨质体积和表面,以及软骨下骨四环素标记的范围。关节软骨的改良曼金评分也显著高于UOC。在注射HA的组中,上述关节软骨和软骨下骨的变化得到改善,观察到的变量与UOC无差异。
使用该动物模型,关节内注射HA似乎限制了早期OA特征性的关节软骨和软骨下骨变化的发展。