van Valburg A A, Wenting M J, Beekman B, Te Koppele J M, Lafeber F P, Bijlsma J W
Department of Rheumatology and Clinical Immunology, University Hospital Utrecht, The Netherlands.
J Rheumatol. 1997 Feb;24(2):358-64.
To investigate whether macroscopically fibrillated human articular knee cartilage observed at autopsy can be considered an early, preclinical phase of osteoarthritis (OA).
Histological and biochemical characteristics of 3 types of articular knee cartilage were compared: macroscopically degenerated knee cartilage obtained at autopsy (6 donors) from donors without clinical history of OA, normal healthy knee cartilage obtained at autopsy (6 donors), and OA cartilage obtained during joint replacement surgery from patients (n = 6) with clinically defined OA of the knee. From the same donors synovial tissue and synovial fluid were obtained and analyzed for features of inflammation.
Histological changes of OA were comparable for degenerated and OA cartilage and significantly different from normal cartilage. Content and synthesis of proteoglycans showed intermediate levels for degenerated tissue compared to normal and OA cartilage. Analysis of synovial tissue revealed a low, mild, and moderate degree of inflammation for joints with normal, degenerated, and OA cartilage, respectively. The same sequence was found for metalloproteinase activity in synovial fluid.
In general, all changes observed in OA joints were, to a lesser extent, observed in the joints with degenerated cartilage and were significantly different from joints with normal cartilage. We conclude that cartilage degeneration observed at autopsy can be considered a preclinical phase of OA, suitable for studying the process of cartilage degeneration in OA.
研究在尸检时观察到的肉眼可见纤维状的人膝关节软骨是否可被视为骨关节炎(OA)的早期临床前期阶段。
比较了3种类型膝关节软骨的组织学和生化特征:从无OA临床病史的供体尸检中获得的肉眼可见退变的膝关节软骨(6名供体)、尸检时获得的正常健康膝关节软骨(6名供体)以及从临床诊断为膝关节OA的患者(n = 6)关节置换手术中获得的OA软骨。从相同供体获取滑膜组织和滑液,并分析其炎症特征。
OA的组织学变化在退变软骨和OA软骨中相当,与正常软骨有显著差异。蛋白聚糖的含量和合成在退变组织中显示出介于正常软骨和OA软骨之间的水平。滑膜组织分析显示,正常、退变和OA软骨的关节炎症程度分别为低、轻度和中度。滑液中的金属蛋白酶活性也呈现相同顺序。
总体而言,在OA关节中观察到的所有变化在退变软骨的关节中在较小程度上也有观察到,且与正常软骨的关节有显著差异。我们得出结论,尸检时观察到的软骨退变可被视为OA的临床前期阶段,适用于研究OA中软骨退变的过程。