Roosendaal G, Vianen M E, Wenting M J, van Rinsum A C, van den Berg H M, Lafeber F P, Bijlsma J W
Van Creveld Clinic, National Haemophilia Centre, University Hospital Utrecht, The Netherlands.
J Bone Joint Surg Br. 1998 May;80(3):540-5. doi: 10.1302/0301-620x.80b3.7807.
Haemophilic arthropathy is characterised by iron deposits in synovial tissues. We investigated the suggestion that iron plays an important role in synovial changes. We obtained synovial tissue from six patients with haemophilia during arthroplasty, finding that brown haemosideritic tissue was often adjacent to tissue with a macroscopically normal appearance in the same joint. Samples from both types of synovial tissue were analysed histologically and biochemically to determine catabolic activity. Macroscopically haemosideritic synovium showed a significantly higher inflammatory activity than that with a normal appearance. Cultures of abnormal synovial tissue gave a significantly enhanced production of IL-1, IL-6 and TNF alpha compared with cultures of synovial tissue with a normal appearance. In addition, the supernatant fluids from the cultures showed greater catabolic activity from haemosideritic tissue, as determined by the inhibition of the synthesis of articular cartilage matrix. We conclude that in patients with haemophilic arthropathy, local synovial iron deposits are associated with increased catabolic activity.
血友病性关节病的特征是滑膜组织中有铁沉积。我们对铁在滑膜变化中起重要作用这一观点进行了研究。我们在关节置换术中从6例血友病患者身上获取了滑膜组织，发现褐色含铁血黄素组织在同一关节内常与外观大体正常的组织相邻。对这两种滑膜组织样本进行了组织学和生化分析，以确定分解代谢活性。肉眼可见含铁血黄素的滑膜显示出比外观正常的滑膜明显更高的炎症活性。与外观正常的滑膜组织培养物相比，异常滑膜组织培养物中白细胞介素-1、白细胞介素-6和肿瘤坏死因子α的产生显著增加。此外，通过抑制关节软骨基质的合成测定，培养物的上清液显示含铁血黄素组织的分解代谢活性更高。我们得出结论，在血友病性关节病患者中，局部滑膜铁沉积与分解代谢活性增加有关。
