Fawthrop F, Yaqub R, Belcher C, Bayliss M, Ledingham J, Doherty M
Rheumatology Unit, City Hospital, Nottingham, United Kingdom.
Ann Rheum Dis. 1997 Feb;56(2):119-22. doi: 10.1136/ard.56.2.119.
To determine if a single time point estimation of chondroitin sulphate (CS) or keratan sulphate (KS) epitopes, hyaluronan (HA), or total glycosaminoglycans (GAG) in knee synovial fluid at time of hospital referral can predict subsequent radiographic progression of knee osteoarthritis.
Two groups of hospital referred patients with knee osteoarthritis were compared: (1) a "progressive" group (n = 45), showing further reduction in radiographic joint space of at least one grade (0-3) in at least one compartment; and (2) a "non-progressive" group (n = 25) in whom radiographs showed no change during the mean follow up period of 2.3 years (median 2, range 1 to 5 years). Knee synovial fluid obtained at the first visit was examined by ELISA for: CS epitopes, using monoclonal antibodies 3B3 and 7D4; KS epitope, using monoclonal antibody 5D4; and HA, using biotinylated HA binding region of cartilage proteoglycan. Total sulphated GAG were measured by dye binding with 1:9 dimethylmethylene blue.
In patients with bilateral synovial fluid data right and left knee values were closely correlated for all variables. There were no significant differences between CS and KS epitopes, HA, total sulphated GAG, or ratios of individual CS or KS epitopes to total GAG, between progressive and non-progressive groups.
Single time point estimation of CS, KS, HA, or total GAG in synovial fluid does not distinguish radiographically progressive and non-progressive knee osteoarthritis patients followed for two years.
确定在医院转诊时对膝关节滑液中硫酸软骨素(CS)或硫酸角质素(KS)表位、透明质酸(HA)或总糖胺聚糖(GAG)进行单次时间点评估,能否预测膝关节骨关节炎随后的影像学进展。
比较两组转诊至医院的膝关节骨关节炎患者:(1)“进展性”组(n = 45),至少一个关节间隙的影像学关节间隙至少降低一个等级(0 - 3级);(2)“非进展性”组(n = 25),在平均2.3年(中位数2年,范围1至5年)的随访期内,X线片显示无变化。首次就诊时获取的膝关节滑液通过ELISA检测:使用单克隆抗体3B3和7D4检测CS表位;使用单克隆抗体5D4检测KS表位;使用软骨蛋白聚糖的生物素化HA结合区域检测HA。通过与1:9二甲基亚甲蓝的染料结合法测量总硫酸化GAG。
在有双侧滑液数据的患者中,左右膝关节的所有变量值密切相关。进展性组和非进展性组之间,CS和KS表位、HA、总硫酸化GAG或单个CS或KS表位与总GAG的比率无显著差异。
对滑液中CS、KS、HA或总GAG进行单次时间点评估,无法区分随访两年的影像学进展性和非进展性膝关节骨关节炎患者。