Traumatic and Degenerative Meniscus Tears Have Different Gene Expression Signatures.
Traumatic and Degenerative Meniscus Tears Have Different Gene Expression Signatures.
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DOI：
10.1177/0363546516664889
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Rai MF
中科院分区：
文献类型：
--
作者：
Brophy RH;Sandell LJ;Rai MF
半月板撕裂根据撕裂方式分为外伤性撕裂和退行性撕裂。几乎没有证据表明两种泪液类型之间存在生物学差异。损伤半月板的基因表达特征在创伤性（垂直）和退行性（复杂、水平或皮瓣）撕裂之间是不同的。48例患者（37例退行性撕裂，11例外伤性撕裂）在临床指示的半月板部分切除术时，从白-白区取出撕裂的半月板样本。采用实时定量聚合酶链反应（pcr）检测损伤半月板mRNA的表达，选择骨关节炎、炎症和软骨稳态的分子标志物（如细胞因子/趋化因子、聚合酶/金属蛋白酶、转录因子、软骨基质基因和脂肪因子）。记录每位患者的撕裂类型（外伤性或退行性）和位置（内侧或外侧）。在调整患者的年龄、性别、体重指数和切除半月板的位置（内侧/外侧）后，计算退行性和外伤性撕裂之间的基因表达差异。基因在半月板撕裂中的表达不同。趋化因子[IL8 （p<0.001）和CXCL6 (p<0.001)]和基质金属蛋白酶[MMP1 （p=0.011）和MMP3 (p=0.016)]在创伤性泪液中的表达水平明显高于退行性泪液。相比之下，COL1A1在创伤性泪液中的表达水平低于退行性泪液（p=0.058）。没有基因测试显示内侧和外侧半月板撕裂有显著差异。与退行性撕裂相比，创伤性半月板撕裂总体上表现出更高的炎症/分解代谢反应，这可以通过更高水平的趋化因子和基质金属蛋白酶表达来证明。这些发现表明创伤性撕裂和退行性撕裂之间存在（分子）生物学上的区别。外伤性撕裂和退行性撕裂之间的分解代谢/炎症差异可能与半月板的治疗决策有关，也有助于我们了解半月板撕裂与膝关节骨关节炎的发展之间的关系。诊断级别III。
Meniscus tears are classified as traumatic or degenerative based on the tear pattern. There is little evidence demonstrating biological differences between the two tear types. Gene expression signatures in the injured meniscus are different between traumatic (vertical) and degenerative (complex, horizontal or flap) tears. Samples of torn meniscus from the white-white zone were removed at the time of clinically indicated partial meniscectomy from 48 patients (37 with degenerative tears and 11 with traumatic tears). The mRNA expression in the injured menisci was measured by quantitative real-time polymerase chain reaction for selected molecular markers of osteoarthritis, inflammation and cartilage homeostasis (e.g. cytokines/chemokines, aggrecanases/metalloproteinases, transcription factors, cartilage matrix genes and adipokines). The tear pattern (traumatic or degenerative) and location (medial or lateral) were recorded for each patient. Gene expression differences between degenerative and traumatic tears were computed after adjusting for patients’ age, sex and body mass index and for location of the resected meniscus (medial/lateral). Gene expression in meniscus tears varied by pattern. Chemokines [IL8 (p<0.001) and CXCL6 (p<0.001)] and matrix metalloproteinases [MMP1 (p=0.011) and MMP3 (p=0.016)] were expressed at a significantly higher level in traumatic tears compared to degenerative tears. In contrast, COL1A1 was expressed at a lower level in traumatic tears compared to degenerative tears (p=0.058). None of the genes tested demonstrated significant differences between medial and lateral meniscus tears. Traumatic meniscus tears overall exhibited higher inflammatory/catabolic response as evidenced by higher levels of chemokines and matrix metalloproteinases expression than degenerative tears. These findings suggest that there is a (molecular) biological distinction between traumatic and degenerative tears. The catabolic/inflammatory differences between traumatic and degenerative tears may be relevant to treatment decisions regarding the meniscus as well as advance our understanding of how meniscus tears relate to the development of knee osteoarthritis. Diagnostic Level III.
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