Fischer U, Kamprad F, Koch F, Ludewig E, Melzer R, Hildebrandt G
Veterinärmedizinische Fakultät, Universität Leipzig.
Strahlenther Onkol. 1998 Dec;174(12):633-9. doi: 10.1007/BF03038512.
Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits.
Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days). An aseptic arthritis in the right knee joint of rabbits was induced by intraarticular injection of 0.5 ml papain solution (3%, 30,000 USP/mg) on day 0. The arthritic knee joint of the anesthesized animals was irradiated daily from day 1 to 5 with 5 times 1.0 Gy. The controls were sham-irradiated under the same conditions. The time course of arthritis in treated animals and sham-treated controls was evaluated by clinical, laboratory-chemical and histological criteria. The clinical investigation was performed daily, the puncture of the knee-joints was carried out several times in EV1, and at the end of experiments in EV2 and EV3. At the end of the observation period, animals were killed and the knee joints excised for histological analysis.
The intraarticular injection of papain caused a peracute inflammatory response in all animals. After 1 week the chronic stage was reached, and the experimental arthritis resolved slowly within several weeks. Local irradiation accelerated the decrease of inflammatory joint swelling, being significant by day 4. On day 6 the volume of synovial fluid in irradiated knee-joints was significantly smaller. The morphometric data indicated a reduction in thickness of synovial membrane, a decrease in number of synovial cell layers, and a decrease in distance between capillaries and the synovial membrane surface following irradiation of arthritic joints. Due to considerable individual variability, the morphometric data partially did not reach statistically significance.
The experiments provide evidence for an antiphlogistic effect of irradiation with 5 times 1.0 Gy in vivo. They support the clinical observations of the efficacy of anti-inflammatory radiotherapy.
大量临床观察表明低辐射剂量在治疗疼痛性骨关节炎方面具有疗效。但实验研究仍然较少。我们研究了每天局部5次1.0 Gy的60钴照射对兔人工诱导的无菌性膝关节炎的影响。
进行了三项独立实验(实验1、实验2、实验3)(每项实验10只兔,5只治疗/5只对照;持续时间:实验1:18天;实验2:6天;实验3:29天)。在第0天通过关节内注射0.5 ml木瓜蛋白酶溶液(3%,30,000 USP/mg)诱导兔右膝关节无菌性关节炎。从第1天到第5天,每天对麻醉动物的关节炎膝关节进行5次1.0 Gy照射。对照组在相同条件下进行假照射。通过临床、实验室化学和组织学标准评估治疗动物和假治疗对照的关节炎病程。每天进行临床检查,在实验1中对膝关节进行多次穿刺,在实验2和实验3结束时进行穿刺。在观察期结束时,处死动物并切除膝关节进行组织学分析。
关节内注射木瓜蛋白酶在所有动物中引起了超急性炎症反应。1周后进入慢性期,实验性关节炎在数周内缓慢消退。局部照射加速了炎性关节肿胀的减轻,在第4天具有显著性。在第6天,照射膝关节的滑液体积明显较小。形态计量学数据表明,照射关节炎关节后,滑膜厚度减小,滑膜细胞层数减少,毛细血管与滑膜表面之间的距离减小。由于个体差异较大,形态计量学数据部分未达到统计学显著性。
实验提供了体内5次1.0 Gy照射具有抗炎作用的证据。它们支持了抗炎放疗疗效的临床观察。